The risk for refractive regression after LASIK was increased in patients with chronic dry eye.

PURPOSE: To examine the effects of laser in situ keratomileusis (LASIK) for hyperopia on the tear film and ocular surface. METHODS: A retrospective 12-month analysis of 88 eyes (88 participants) who had LASLK for hyperopia was performed. Participants were evaluated before and after (2 weeks, 1, 3, ?, and 12 months) surgery for dry eye symptoms (McMonnies Dry Eye Survey primary symptoms), tear film stability (fluorescein break-up time), tear volume (phenol red thread test), ocular surface staining (fluorescein), and conjunctival goblet cell density. RESULTS: Chronic dry eye was experienced by 32% of participants; symptoms were significantly associated with female gender, preoperative dry eye symptoms, lower tear film stability after surgery, greater ocular surface staining after surgery, lower tear volume before and after surgery, and lower goblet cell densities after surgery. Regression rate 12 months after surgery was 32% and significantly associated with female gender, chronic dry eye symptoms, lower tear film stability after surgery, greater ocular surface staining before and after surgery, and lower tear volume before and after surgery. CONCLUSIONS: Dry eye, particularly in females, is problematic after LASLK for hyperopia and is associated with refractive regression. Current methods for managing the tear film and ocular surface may not control LASLK-induced dry eye, particularly in some females during the first 6 months after surgery. [J Refract Surg 2002;18:113-123]

The risk of chronic dry eye after LASIK was significantly higher in Asian eyes. Contributing factors could include racial differences in eyelid and orbital anatomy, tear film parameters and blinking dynamics and higher attempted refractive corrections in Asian eyes.

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In this series, no patient reported intraoperative or postoperative discomfort and surgical results were excellent in terms of visual outcome and IOP control.