Does Central Fat Distribution Reduction After Bariatric Surgery Induce Ocular Refraction Change Independent of Body Mass Index?

The effect of body mass index (BMI) and central fat distribution (CFD) reduction after bariatric surgery on ocular refraction is not well established. We assessed association between anthropometric parameters and refraction errors with other ocular and metabolic parameters 1 year after the surgery. This was a retrospective study with patients underwent bariatric surgery and had at least 1 year follow-up. Data were extracted from the bariatric and ophthalmology outpatient clinic records of the participants. Measurements of metabolic, anthropometric, and ocular parameters including BMI, CFD, refraction status, visual acuity, intraocular pressure (IOP), optic coherence tomography (OCT), and biometry test of the eyes were evaluated. Seventy-four eyes of 37 patients had a mean follow-up of 14.4 ± 1.7 months after the surgery. Mean BMI and percentage of CFD decreased from 47.5 ± 6.7 to 33.1 ± 5.2 kg/m2 (p < 0.01) and 28.5 ± 5.74 to 17.8 ± 4.64 (p < 0.001) after 1 year, respectively. Mean refractive errors of the right and left eyes changed from - 0.62 ± 1.23 D to - 0.17 ± 1.36 D and from - 0.79 ± 1.39 to - 0.34 ± 1.56 after 1 year of the surgery (p < 0.001). Mean IOP was significantly reduced (p < 0.001). Unlike BMI, reduction in CFD was significantly correlated with refraction change in both eyes (right eyes; r = 0.783, left eyes; r = 0.791, p < 0.001) after 1 year. No significant differences were found in the other parameters. Bariatric surgery induced significant refractive change in eyes, which is significantly associated with CFD reduction after 1 year. Bariatric surgery should be considered as a risk factor in patients with unexpected refractive error changes.