- lifestyle report
TFOS Lifestyle: Impact of elective medications and procedures on the ocular surface
Jos´e Alvaro P. Gomes a,1,*, Dimitri T. Azar b,2, Christophe Baudouin c, Etty Bitton d, Wei Chen e, Farhad Hafezi f, Pedram Hamrah g, Ruth E. Hogg h, Jutta Horwath-Winteri, Georgios A. Kontadakisj, Jodhbir S. Mehta k, Elisabeth M. Messmer, Victor L. Perez m, David Zadok n, Mark D.P. Willcox o
a Dept. of Ophthalmology and Visual Sciences, Federal University of Sao Paulo/Paulista School of Medicine (UNIFESP/EPM), Sao Paulo, SP, Brazil b University of Illinois College of Medicine, Chicago, IL, USA c Quinze-Vingts National Eye Hospital & Vision Institute, IHU FOReSIGHT, Paris, France d Ecole d’optom´etrie, Universit´e de Montr´eal, Montr´eal, Canada e Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China f ELZA Institute, Dietikon, Switzerland g Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA h Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Belfast, UK i Department of Ophthalmology, Medical University of Graz, Graz, Austria j Institute of Vision and Optics, University of Crete Medical School, Crete, Greece k Singapore National Eye Centre, Singapore l Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany m Foster Center for Ocular Immunology, Duke University Eye Center, Durham, NC, USA n Shaare Zedek Medical Center, Affiliated to the Hebrew University, School of Medicine, Jerusalem, Israel o School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
ARTICLE INFO
Keywords:
Quality of life
Ocular surface disease
Drug-related adverse reactions
Cosmetic surgery
Oculoplastic surgery
Refractive surgery
Eyelids
Cornea
Conjunctiva
Systematic review
ABSTRACT
The word “elective” refers to medications and procedures undertaken by choice or with a lower grade of prioritization. Patients usually use elective medications or undergo elective procedures to treat pathologic conditions or for cosmetic enhancement, impacting their lifestyle positively and, thus, improving their quality of life. However, those interventions can affect the homeostasis of the tear film and ocular surface. Consequently, they generate signs and symptoms that could impair the patient’s quality of life. This report describes the impact of elective topical and systemic medications and procedures on the ocular surface and the underlying mechanisms. Moreover, elective procedures performed for ocular diseases, cosmetic enhancement, and non-ophthalmic interventions, such as radiotherapy and bariatric surgery, are discussed. The report also evaluates significant anatomical and biological consequences of non-urgent interventions to the ocular surface, such as neuropathic and neurotrophic keratopathies. Besides that, it provides an overview of the prophylaxis and management of pathological conditions resulting from the studied interventions and suggests areas for future research. The report also contains a systematic review investigating the quality of life among people who have undergone small incision lenticule extraction (SMILE). Overall, SMILE refractive surgery seems to cause more vision disturbances than LASIK in the first month post-surgery, but less dry eye symptoms in long-term follow up.
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