Document Type

Article

Publication Date

2026

DOI

10.3389/fmed.2025.1623324

Publication Title

Frontiers in Medicine

Volume

12

Pages

1623324

Abstract

Background: Ocular surface disease is a multifactorial condition that is very commonly caused by dry eye disease (DED). Ophthalmic procedures intended to improve visual outcomes, laser-assisted in situ keratomileusis (LASIK) and cataract surgery, can paradoxically cause or exacerbate underlying ocular surface disease. This results in worsening vision and quality of life.

Areas covered: This review examines the pathophysiological mechanisms contributing to ocular surface disease development following LASIK and cataract surgery. Both procedures are associated with the transection of corneal nerves, leading to decreased tear production, surface instability, altered neurotrophin production, and impairment of the blink reflex. Furthermore, these incisional procedures stress ocular tissues, while the use of preservatives in topical medications administered during or after these procedures may exacerbate dry eye symptoms. Management strategies for postoperative dry eye disease include, but are not limited to, the use of artificial tears, anti-inflammatory agents such as cyclosporine A or lifitegrast, nerve growth factor therapies, and procedural interventions including punctal plugs, thermal pulsation, lid exfoliation, and intense pulsed light therapy. Additionally, artificial intelligence has emerged as a promising tool to enhance the selection of optimal candidates, thereby minimizing risk and optimizing postoperative outcomes and improving patient satisfaction.

Discussion: LASIK and cataract surgery are highly effective vision correction procedures that have constantly evolved to improve visual outcomes and mitigate side effects. However, ocular surface diseases remain a common complication affecting the outcome and quality of life of post-operative patients. The integration of personalized treatment and AI-based screening protocols can help improve patient outcomes.

Rights

© 2026 Spangler, Kirupaharan and Sheppard. 

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owners are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Original Publication Citation

Spangler, M. D., Kirupaharan, N., & Sheppard, J. D. (2026). Ocular surface disease following LASIK and cataract surgery: A review of their interrelated complications. Frontiers in Medicine, 12, Article 1623324. https://doi.org/10.3389/fmed.2025.1623324

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