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    AAO 2018 Video Program
    Refractive Mgmt/Intervention

    Though the science of refractive surgery has advanced tremendously, there is a distinct subset of patients who are unhappy after refractive surgical correction due to dry eye, glare, or poor quality of vision. Thus, a detailed scientific approach is required to decipher the sequence of events leading to patient dissatisfaction, which include

    • preoperative factors such as topography, aberrations, tear film quality, and tear biomarkers
    • intraoperative factors such as type or duration of surgery, epithelial integrity, and ease of flap dissection
    • postoperative factors including medical therapeutic regimes

    This enables us to predict and modify the outcomes of this subset of patients. Using retrospective case analysis, we propose a model to acquire a deeper understanding of the reasons behind patient unhappiness, taking into account patient personality, optics, and ocular-surface cell markers, thus transforming our results from a 20/20 unhappy patient to a 20/20 happy patient.