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Corneal sensation, dry eye affected by LASIK hinge width
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ROCKVILLE CENTRE, N.Y. — Use of a wider, nasal LASIK hinge results in an increase in corneal sensation and a decrease in signs and symptoms of dry eye up to 3 months postoperatively, according to a prospective trial.
Eric D. Donnenfeld, MD, and colleagues performed a masked trial in 54 patients in which they measured the actual chord length of the LASIK hinge rather than the flap thickness. All patients underwent bilateral LASIK with a nasal hinge using the AMO Amadeus microkeratome. Follow-up was at 1 day, 1 week, 1 and 3 months.
“We randomly assigned one eye to a wider hinge of 1.2-mm chord length and the second eye to a 0.6-mm chord length,” Dr. Donnenfeld said. Mean corneal sensation was normal preoperatively. It dropped at 1 week, then increased at the 1- and 3-month visits.
“With the wider hinge, there was statistically more sensation at these two visits,” Dr. Donnenfeld said.
Four patients with the thinner hinge and one with the wider hinge had significant corneal staining at a week postoperatively. “This continued at 1 month. At 3 months, there was no corneal staining with the wider hinge, but four patients had corneal staining with the thinner hinge,” Dr. Donnenfeld said.
Tear breakup time was not statistically different between the two groups, but Schirmer testing showed a trend toward better scores with the wider hinge.
Dr. Donnenfeld said he believes many patients who exhibit dry eye post-LASIK had dry eyes before the surgery as well.
More details on Dr. Donnenfeld’s study are published in the Oct. 15 print edition of Ocular Surgery News U.S. Edition.