Non-Conservative Therapy in the Prevention of Subepithelial Fibroplasia after LASEK Hypermetropia Correction

Abstract

The results of observation of patients who underwent vision eximerlaser correction by the LASEK method regarding medium degree of hyperopia were analyzed.Purpose:to investigate the severity of the «dry eye» syndrome and corneal subepithelial fibroplasia in patients after laser correction of hyperopia by the LASEK method, and their prevention by reducing the preservative action on the eye surface.Patients and methods.The study included 40 patients (76 eyes), aged 21–46 years (32.98 ± 1.79) who underwent LASEK surgery for moderate hyperopia (4.03 ± 0.38 D). Patients were divided into two groups: 1) control group (20 patients, 37 eyes) — postoperative therapy included the corneoprotector “Stilavit®” and the preparation of hyaluronic acid “Oksial®”, containing preservatives; 2) the study group (20 patients, 39 eyes) — postoperative therapy included the corneoprotector “Hilozar-comod®” and the artificial tear preparation “Hilo-comod®”, which did not contain reservatives. Ophthalmic examination included, in addition to standard diagnostic methods, the Norn test, the Schirmer test, the staining of the eye surface with lissamine green. In addition, a questionnaire was conducted on a modified OSDI questionnaire; there a section characterizing the quality of vision (section B) was removed.Results.The analysis of the obtained data showed that in the study group there was less pronounced “dry eye” syndrome at 3,6,12 months after the operation. The maximum difference in the indicators of the “dry eye” syndrome between the groups was at 3 and 6 months of the postoperative period. When evaluating corneal subepithelial fibroplasia, maximum attention was paid to the frequency and the intensity index. It was shown a significant difference in the intensity of the haze between the study group and the control group by 26.1 % at 3 months, by 62.2 % at 6 months and by 65.3 % 12 months after the operation. Conclusion.Nonconservative therapy with sodium hyaluronate and dexapanthenol in the early postoperative period and only sodium hydrolurate allows to reduce the severity of the dry eye syndrome after laser correction of hypermetropia and, as a result, to reduce the intensity of haze development by 65.3 %, and its frequency on 11,5 %.