Şule Barman KAKIL, Neşe ARSLAN
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(2):315-322
Objective: To evaluate the impact of cigarette smoking on ocular surface parameters and inner retinal structure, and to explore the potential for reversibility following smoking cessation. Material and Methods: This cross-sectional study included 100 participants divided into four groups based on smoking status: Group 1 (non-smokers), Group 2 (current smokers <10 years), Group 3 (current smokers >10 years), and Group 4 (former smokers, >1 year cessation). All participants underwent detailed ophthalmic evaluation including tear film break-up time (TBUT), Schirmer test, Ocular Surface Disease Index (OSDI), meibography, noninvasive TBUT (NITBUT), and spectral-domain optical coherence tomography for ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) thickness. Correlations between daily cigarette consumption and ocular parameters were analyzed. Results: Current smokers (Groups 2 and 3) exhibited significantly lower TBUT, Schirmer, and NITBUT values, and higher OSDI scores compared to non-smokers (Group 1) and former smokers (Group 4) (p < 0.01). Meibomian gland loss was significantly elevated in current smokers, especially in Group 3. OCT analysis revealed thinner GCC and RNFL layers in chronic smokers (p < 0.05). Former smokers showed values closer to non-smokers, suggesting a possible improvement pattern. Among active smokers, daily cigarette intake negatively correlated with TBUT (r = -0.41, p = 0.004), Schirmer (r = -0.35, p = 0.01), GCC (r = -0.38, p = 0.006), and RNFL thickness (r = -0.28, p = 0.045). Conclusion: Chronic cigarette smoking is associated with significant ocular surface dysfunction and early retinal structural changes. These effects demonstrate a dose-dependent pattern and may be partially reversible upon cessation. Early screening and cessation counseling may mitigate long-term ocular damage in smokers.
