Discussion
HOA, LASIK, congestion, conjunctival congestion, potentially reduced postoperative inflammation
CONGESTION
To reduce the incidence and severity of refractive surgery-related DED, a comprehensive management approach throughout the perioperative period is needed. The current consensus recommended that both the preoperative identification and treatment of DED, and postoperative tear replacement, tear conservation, and anti-inflammation therapies, should be implemented [Our results demonstrate that MCG treatment effectively conserved tear and stabilized the postoperative tear film. TMH was significantly higher in the MCG group compared to control 1 week and 1 month postoperatively in SMILE participants, and 1 day in FS-LASIK participants. Despite the lack of statistical significance, TMH was generally higher in the MCG groups in both SMILE and FS-LASIK participants. Previous studies reported a significant increase in TMH after the application of moisture chamber goggles [In both SMILE and FS-LASIK control groups, NIBUT at postoperative 1 day postoperative decreased significantly compared to preoperatively, but not in the corresponding MCG groups. This is consistent with previous observations that MCG can elongate BUT and stabilize the tear film [MCG can ameliorate conjunctival congestion after refractive surgery. The congestion scores were generally lower in the MCG groups compared to the control groups. The effect of MCG on the lipid layer of the tear film is less clear. Average LLT was significantly lower in the FS-LASIK MCG group 1 week postoperatively. No significant trend in the homogeneity of lipid layer distribution was observed. As MCG mainly inhibit the evaporation of the tear film, they are less likely to affect the lipid layer. A previous study on MCG with heating functions showed that increased temperature can lead to increased LLT [A significant decrease in total HOA was observed after both SMILE and FS-LASIK surgery and further improved by the use of the MCG. In the FS-LASIK MCG group, total HOA was significantly lower compared to the control group, at 1 day and 1 week after surgery. Previous studies have demonstrated that DED was associated with increased HOAs and poor visual quality and that DED interventions have led to improvement in both tear film stability and HOAs [The postoperative OSDI scores were generally lower in the MCG groups compared to the control, despite the lack of statistical significance. This demonstrates that the use of MCG can ameliorate postoperative discomfort in both SMILE and FS-LASIK recipients. In addition, a significant increase in OSDI scores was observed in the FS-LASIK control group, reflecting a higher level of discomfort induced by this surgery. This observation was consistent with previous reports that SMILE was associated with less postoperative discomfort than FS-LASIK [This is the first study investigating the efficacy of MCG on DED after refractive surgery. Previous studies mainly focused on the short term effects of MCG, making this study an important addition to current knowledge on the effects of moisture chamber goggles. This study uses non-invasive techniques for tear film evaluations, thereby reducing the disturbance of tear film during examinations. This study has a few important limitations. The variance in NIBUT and LLT is large, despite repeated examinations. However, this variation was consistent with previous reports [In conclusion, our results demonstrated the efficacy of MCG in refractive surgery-related DED. MCG usage effectively slowed tear evaporation, increased tear film stability, improved HOAs, and potentially reduced postoperative inflammation and discomfort in patients receiving SMILE and LASIK surgeries. MCG is a promising adjuvant therapy in the comprehensive management of refractive surgery-related DED.