Association Between Preoperative Negative Emotional States and Eye Movement During Photorefractive Keratectomy

Published date: Jan 06 2026

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: ‎Volume 20 - 2025

Pages: 1 - 8

DOI: 10.18502/jovr.v20.17300

Hesam Hashemianseyedmohammadjazayeri5@gmail.comFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran

Hooman Ahmadzadehhooman.ahmadzadeh@gmail.comFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran

Alireza Razavirazavialireza33@gmail.comFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran

Hassan Asadignadomanihasanasadigandomani0800@gmail.comTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Science, Tehran

Zahra Montazerianiresearcher1@gmail.comDepartment of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences and Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran

Sogol Olamazadehresearcher2@gmail.comFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran

Mehdi Khodaparastmehdikhodaparastzavare@gmail.comFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran

Purpose: To describe the link between negative emotions—depression, anxiety, and stress—and eye movement during photorefractive keratectomy (PRK).

Methods: This comparative case series was conducted on 53 PRK candidates and involved completing the Depression, Anxiety, and Stress Scale (DASS-21) before surgery. Eye movement, measured as the radial distance between the pupil and laser center during each shot, was analyzed. Average distance indicated centralization accuracy, while standard deviation (SD) indicated precision. Stress, depression, anxiety, and their relationship with eye movement during PRK were studied.

Results: The mean and SD of eye movements were not significantly correlated with depression, anxiety, stress, or the total DASS-21 score. A weak negative correlation was observed between the preoperative spherical equivalent (SE) and stress (r = –0.305, P = 0.004), anxiety (r = –0.401, P < 0.001), and total DASS-21 scores (r = –0.324, P = 0.002). Lastly, a weak positive correlation was found between ablation time and the SD of eye movement (r = 0.473, P < 0.001).

Conclusion: The DASS-21 questionnaire showed no link between negative emotions and eye movement. Additionally, longer ablation times correlated with greater SD of eye movement.

Keywords: Anxiety, DASS-21, Depression, Photorefractive Keratectomy, Stress

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