Corneal Refractive Surgery-related Dry Eye

Risk Factors and Management

Louis Tong; Yang Zhao; Ryan Lee

Expert Rev Ophthalmol. 2013;8(6):561-575.

Epidemiology

Dry eye is a common complication after photorefractive surgery. The incidence of post-LASIK dry eye ranged between 8.3 and 48.0% based on symptomatic and/or objective findings assessed at least 6 months post-operatively.^[5–9] However, comparison of these studies is not possible due to their differing diagnostic criteria for dry eye.

To date, no study has looked at the incidence or prevalence of chronic, persistent post-LASIK dry eye beyond the 6-month post-operative mark. It is uncertain if incidence of post-operative dry eye in the short term (1 day to 1 month) is a predictive factor for the development of chronic dry eye in the longer term (more than 6 months).

1 2 3 4 5 6 7 8

Next Section

Table 1. Studies investigating effect of hinge position on dry eye outcomes.
Study (year)	Sample size (eyes)	Hinge positions compared	Duration of follow-up (months)	Randomized or not	Corneal sensation	Schirmers test	TBUT	Corneal staining	Dry eye symptoms	Ref.
Donnenfeld et al. (2003)	104	Superior vs nasal	6	Yes	Worse in superior	No difference	No difference	Worse in superior	Not compared	[74]
Lee et al. (2003)	50	Superior vs nasal	6	Yes	Not compared	Worse in superior ^†	Worse in superior ^†	Not compared	Not compared	[76]
Huang et al. (2012)	86	Superior vs nasal	6	No	No difference	No difference	No difference	No difference	No difference	[78]
Mian et al. (2009)	56	Superior vs temporal	12	Yes	No difference	No difference	No difference	No difference	No difference	[79]
Vroman et al.(2005)	94	Superior vs nasal	6	Yes	No difference	No difference	No difference	No difference	No difference	[80]

^†Differences were observed at the 2-month interval after operation. Data at 6 months not reported.

Table 2. Table comparing different ablation laser platforms.
Study (year)	Laser systems compared	Sample size (number of eyes)	Duration of follow-up	Randomized or not	Dry eye parameters measured	Difference observed	Ref.
Flap creation laser platforms
Petznick et al. (2013)	Low-energy laser with corneal suction ^† versus high-energy laser with conjunctival suction ^‡	90	3 months	Randomized	Tear break-up time, Schirmer's test, corneal fluorescein staining, corneal sensitivity	None	[86]
Laser ablation platforms
Foo et al. (2011)	Conventional ^§ versus tissue-saving ^¶ versus wavefront-guided^#	72	3 months	Non-randomized	Tear lipid layer thickness ^‡‡, non-invasive tear break-up time ^‡‡, tear meniscus height	None	[88]
Moshirfaret al. (2011)	Wavefront-guided ^# versus wavefront-optimized ^††	44	3 months	Randomized	Schirmer's test	None	[87]