To determine the prevalence of preoperative dry eye disease and evaluate tear film function in refractive surgery candidates in China.
In this prospective noninterventional cross-sectional study, refractive surgical candidates from 13 pre-selected eye hospitals in China were recruited from July 2015 to February 2016. Patient histories, subjective symptoms, tear film breakup time (TBUT), ocular surface fluorescein staining, and Schirmer I tests (SIT), were assessed to conduct subgroup analysis.
A total of 1849 patients were recruited, 41.4% were diagnosed with dry eye disease (766/1849) and 44.9% (830/1849) of subjects had a positive history of contact lens wear. The overall mean TBUT and SIT values were 7.3 ± 3.7s and 15.2 ± 8.8mm, respectively. The total prevalence of ocular surface fluorescein staining was 23.46% (422/1849). 44.62% of patients had TBUT <5s, 23.20% of patients had SIT <5mm. Contact lens wearers were observed to have a higher prevalence of dry eye than non-contact lens wearers (54.1% vs 35.2%, OR=2.17, 95%CI: 1.77-2.65).
In this study, the most common abnormal finding in dry eye disease was tear film instability. A high proportion of refractive surgery candidates have preexisting dry eye disease and a history of contact-lens wear prior to surgery. Careful attention should be given to the evaluation of preoperative dry eye in refractive surgery candidates.

© 2020 S. Karger AG, Basel.