Prevalence of self-reported dry eye symptoms after refractive surgery among Saudi adults: A cross-sectional survey

Refractive surgery corrects vision using different corneal techniques; however, dry eye disease (DED) is one of its commonest side effects. This descriptive survey questionnaire-based study aimed to evaluate prevalence and factors associated with dry eye symptoms after refractive surgery among survey respondents using ocular surface disease index (OSDI) questionnaire in Saudi Arabia. Four hundred and thirty nine participants were included. Dry eye OSDI scores compared across different epidemiological risk factors, focusing on refractive surgery type and postoperative duration. Photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK) or Femtosecond (FS)-LASIK, and small incision lenticule extraction procedures were performed on 201 (45.79%), 222 (50.56%), and 16 (3.65%) participants, respectively. According to OSDI scores, 391 participants (89.1%) had dry eye symptoms after surgery, with 69.5% classified as severe, 11.4% as moderate, 8.2% as mild, and only 10.9% as normal. Insignificant gender differences were observed; however, OSDI-defined dry eye symptoms prevalence was lower in Eastern Province and in participants with longer post-surgery durations. Participants who underwent PRK reported higher prevalence of OSDI-defined dry eye symptoms versus those underwent LASIK/FS-LASIK. In conclusion, Self-reported OSDI-defined DED were common after refractive surgery, especially after PRK. Females and early post-surgery patients have more severe OSDI-defined dry eye symptoms. Living in a humid area (Eastern Province) may reduce risk of OSDI-defined DED post-surgery.