Lubricating gels can affect refractive surgery outcome, study suggests

VERACRUZ, Mexico — The quality of the tear film should be taken into consideration when planning photorefractive surgery, according to a surgeon speaking here.

At the Mexican Congress of Ophthalmology meeting this week, Maria Gomez Valcarcel, MD, presented findings on the effect of lubricating gels on optical aberrations after refractive surgery. She and colleagues sought to establish that changes in the tear film due to lubricating gels can induce alterations that affect the outcome of refractive surgery.

“Our objective in this study was to determine the changes in aberrations caused by lubricating gel,” Dr. Gomez Valcarcel said.

The study included 30 eyes of patients younger than 40 who underwent a baseline aberrometry exam in both eyes. The measurements were taken again at 1, 5, 15 and 30 minutes after lubricating gel was applied to their eyes.

The study found that aberrations in the eyes increased in a clinically significant way. The one exception was defocus, which was found to decrease. The results were not statistically significant in most cases, Dr. Valcarcel said.

She noted that gels have not been found to significantly impact lower-order aberrations.

One area that showed “an important decline” after the application of the gel is the match (the percentage of spherocylindrical ablation that can be programmed to be corrected).

“In calculating photorefractive surgery, one must consider the tear film in order to validate the match (percentage) that is being measured,” Dr. Valcarcel said.