Dry Eye after Lasik for Myopia: Incidence and Risk Factors

Shoja, M R; Besharati, Mohammad Reza

doi:10.1177/112067210701700101

Cited by 113 publications

(102 citation statements)

References 27 publications

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“…19 Similar results have been demonstrated by various authors. 20,21 Li et al found that patients in the SMILE group had less corneal staining and greater central corneal sensitivity scores than patients in the FS-LASIK group.…”

Section: Discussionsupporting

confidence: 81%

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Ganesh¹,

Gupta²

2014

J Refract Surg

187

147

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ASIK is the most popular refractive surgery for myopic laser correction to date. The use of femtosecond laser-assisted LASIK (FS-LASIK) offers the creation of more predictable flaps with regard to flap thickness, diameter, and hinge width. 1,2Even with high success rates, side effects such as increased postoperative dryness, reduced biomechanical corneal strength, induction of higher-order aberrations (HOAs), postoperative glare, halos, and flap-related complications remain. 3-5More recently developed is refractive lenticule extraction, which uses a femtosecond laser to create an intrastromal corneal lenticule (the removal of which alters the shape of the cornea), thereby correcting myopia. It encompasses two different techniques: femtosecond lenticule extraction (FLEX) and small-incision lenticule extraction (SMILE).SMILE is a more recent flapless subtype in which the lenticule is extracted through a small arcuate incision (2 to 4 mm). This allows for greater stability because most of the Bowman's layer remains intact.Studies have shown that SMILE is associated with lower topographic changes and less inflammation and keratocyte apopotosis than FS-LASIK, particularly for higher levels of correction of myopia. 6,7 Because the procedure is flapless, most flap-related complications are not observed with SMILE.The aim of the current study was to evaluate the efficacy and safety of SMILE compared with FS-LASIK. Our primary hypothesis (null hypothesis) states that SMILE is better or comparable to LASIK for correction of myopia in terms of refractive accuracy and quality of vision (ie, postoperative aberrations and contrast sensitivity). Primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity wavefront aberrations, and tear film abnormalities. L ABSTRACT PURPOSE: To compare the visual and refractive outcomes of femtosecond laser-assisted LASIK with smallincision lenticule extraction (SMILE) in terms of visual acuity, contrast sensitivity, aberrations, and dry eye. METHODS:A single-center prospective randomized study in which patients diagnosed as having myopia presenting for refractive correction were allocated to either a LASIK or SMILE group. The primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity, aberrations, and dry eye status. Patients were followed up at days 1 and 15 and 3 months; postoperative uncorrected visual acuity (UCVA), aberrations, dry eye, and contrast sensitivity were recorded and compared to preoperative data. Two postoperative subjective questionnaires were used to assess pain, pricking sensation, redness, glare, and overall patient satisfaction. RESULTS:At day 1 postoperatively, 48 (96%) of 50 eyes in the SMILE group achieved a UCVA of 20/20 compared with 46 (92%) of 50 eyes in the LASIK group. At day 15 postoperatively, contrast sensitivity was similar in the two groups (P = .15), but by 3 months, it was better in the SMILE group than the LASIK group at all spatial frequencies (...

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Section: Discussionsupporting

confidence: 81%

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Ganesh¹,

Gupta²

2014

J Refract Surg

187

147

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“…24 sistent with prior studies that showed at least temporary worsening after LASIK surgery. 26,27,34 In the PROWL studies, clinicians collected information on clinical signs of dry eyes, possibly leading to greater detection and more aggressive treatment of dry eye problems. In addition, mechanical keratomes were used in less than 3% of cases in the PROWL studies.…”

Section: Discussionmentioning

confidence: 99%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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IMPORTANCE Patient-reported outcomes should be collected using validated questionnaires prior to and following laser in situ keratomileusis (LASIK) surgery.OBJECTIVE To report the frequency of patient-reported visual symptoms, dry eye symptoms, satisfaction with vision, and satisfaction with LASIK surgery in the Patient-Reported Outcomes With LASIK (PROWL) studies. DESIGN, SETTING, AND PARTICIPANTSThe PROWL-1 and PROWL-2 studies were prospective, observational studies conducted from September 13, 2011, to June 27, 2014. The PROWL-1 study was a single-military center study of 262 active-duty Navy personnel 21 to 52 years of age. The PROWL-2 study was a study of 312 civilians 21 to 57 years of age conducted at 5 private practice and academic centers. The LASIK surgery and the postoperative care were performed based on the usual practice and clinical judgment at the site. Participants completed a self-administered, web-based questionnaire, preoperatively and postoperatively at 1 and 3 months (the PROWL-1 and -2 studies) and at 6 months (the PROWL-2 study).EXPOSURES Participants underwent LASIK surgery for myopia, hyperopia, and/or astigmatism. MAIN OUTCOMES AND MEASURESVisual symptoms (double images, glare, halos, and/or starbursts), dry eye symptoms, participant satisfaction (with vision and LASIK surgery), and clinical measures (visual acuity, refractive error, and slitlamp and posterior segment eye examination findings) were assessed preoperatively and at 1, 3, and 6 months postoperatively.RESULTS A total of 262 participants were enrolled in the PROWL-1 study (mean [SD] age, 29.1 [6.1] years), and a total of 312 participants were enrolled in the PROWL-2 study (mean [SD] age, 31.5 [7.3] years). Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months). The percentages of participants in the PROWL-1 study with normal Ocular Surface Disease Index scores were 55% (95% CI, 48%-61%) at baseline, 66% (95% CI, 59%-72%) at 3 months, and 73% (95% CI, 67%-79%) at 6 months. The percentages of participants in the PROWL-2 study with normal Ocular Surface Disease Index scores were 44% (95% CI, 38%-50%) at baseline and 65% (95% CI, 59%-71%) at 3 months. Of those participants who had normal scores at baseline in both the PROWL-1 and -2 studies, about 28% (95% CI, 19%-37%) had mild, moderate, or severe dry eye symptoms at 3 months. While most participants were satisfied, the rates of dissatisfaction with vision ranged from 1% (95% CI, 0%-4%) to 4% (95% CI, 2%-7%), and the rates of dissatisfaction with surgery ranged from 1% (95% CI, 0%-4%) to 2% (95% CI, 1%-5%). CONCLUSIONS AND RELEVANCEThe systematic administration of a questionnaire to patients who have undergone LASIK surgery is a new approach to assess symptoms and satisfaction. Our findi...

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“…1,2 There are many causes and factors leading to dry eye, including aging, female gender, connective tissue diseases, diabetes mellitus, systemic hypertension, contact lens usage, drugs like antihistamines, anticholinergics, antidepressants, oral contraceptives and topical eye drops containing preservatives and ocular diseases like blepharitis, chronic conjunctivitis, meibomitis and pterygium. [3][4][5] Dry eye is the most frequent disorder in ophthalmology practice. The prevalence of which varies from 4% to 57%, thereby showing disparity worldwide.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of dry eye after Phacoemulsification in senile cataract

Gupta¹,

Mittal²,

Shakeel³

et al. 2015

Int J Res Med Sci

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Dry Eye after Lasik for Myopia: Incidence and Risk Factors

Abstract: Patients undergoing LASIK for myopia develop dry eye with compromised tear function at least 6 months after surgery. Women and patients requiring higher refractive correction have an increased risk for developing dry eye.

Cited by 113 publications

References 27 publications

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

Comparative study of dry eye after Phacoemulsification in senile cataract

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