Corneal thickness measurement is important for assessing intraocular pressure in patients with glaucoma. This study investigated the changes in corneal epithelial thickness (CET) induced by antiglaucoma medications and explored the factors affecting CET measurement. CET was measured over a 9.0 mm diameter area by using Fourier domain optical coherence tomography in 125 patients with primary open-angle glaucoma and 125 age-matched controls without glaucoma. The influence of sex, age, benzalkonium chloride (BAK)-containing instillations, disease severity, and types and numbers of medications was analyzed using simple and multiple regression analyses. CET over 25 sectors was smaller in the glaucoma group than in the control group (mean difference of 4.2 µm in the central 2.0 mm zone; 52.8 ± 3.6 vs. 48.5 ± 3.9, p < 0.001). Simple regression analysis revealed age, use of β-blockers, prostaglandin, carbonic anhydrase inhibitors, total number of medications, and number of daily BAK-containing instillations were associated with a thinner epithelium. Multiple regression analysis revealed β-blockers, prostaglandin, and number of BAK-containing instillations were significant factors. Use of β-blockers and number of BAK-containing instillations were also associated with a thinner epithelium in the monotherapy subgroup analysis. CET was significantly smaller in patients with glaucoma receiving topical medications and was affected by the use of β-blockers, prostaglandin, and BAK.

Ocular aberrations, particularly corneal higher-order aberrations (HOAs), which impair visual quality, should be minimized or corrected during any laser vision correction. We compared changes in visual outcomes, including HOAs, in patients who underwent Topography-Guided laser-assisted in situ keratomileusis (TG-LASIK) or small-incision lenticule extraction (SMILE) after propensity score matching (PSM) to reduce selection bias. Of 2749 patients who underwent SMILE or TG-LASIK for myopia, 152 eyes underwent complete ophthalmic examination preoperatively and over six months postoperatively. Visual outcomes were comparatively analyzed after PSM. As a result, 45 eyes were included in each group after PSM. There was a comparable improvement in visual acuity (VA) and refractive parameters postoperatively, with no difference between the two PSM-groups. However, 6.6% in the SMILE PSM-group lost two or more lines of Snellen VA at the six-month follow-up, while none in the TG-LASIK PSM-group did. Specifically, the SMILE PSM-group showed a significant increase in corneal HOAs, including spherical aberration, coma, and total HOAs (0.0736 ± 0.162 μm; 0.181 ± 0.233 μm; and 0.151 ± 0.178 μm, respectively), whereas TG-LASIK PSM-group did not. Furthermore, SMILE PSM-group had greater postoperative corneal HOAs than those in TG-LASIK PSM-group. Collectively, TG-LASIK induces fewer corneal HOAs even after facilitating between-group comparability using PSM analysis. TG-LASIK provides better visual quality than SMILE for myopia.