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No effect from flap position on dry eye after femtosecond LASIK

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Performing LASIK using femtosecond laser-created flaps can lead to loss of corneal sensation and mild symptoms of dry eye, regardless of whether a superior or temporal hinge is used, a prospective study found.

Shahzad I. Mian, MD, and colleagues at the University of Michigan investigated whether the hinge position of LASIK flaps created with the IntraLase FS laser (Advanced Medical Optics) affected corneal sensation and dry eye symptoms. The study included 66 consecutive eyes of 33 patients treated at an average age of 40.8 years.

The researchers randomly assigned one eye of each patient to undergo LASIK involving either a superior hinge or a temporal hinge. The contralateral eye was treated with whichever hinge was not used on the first eye, according to the study.

Both hinge groups had a similar preoperative refractive error and corneal thickness, although eyes treated with a temporal hinge had a greater average ablation depth.

The researchers found that corneal sensation had significantly reduced in both hinge groups up to 12 months after surgery, with no significant differences between the groups.

Both groups also had a significant increase in dry eye symptoms at 1 week and 1 month follow-up compared with preop. However, symptoms were mild at all time points, the study authors noted.

At 1 week follow-up, the Ocular Surface Disease Index score averaged 11.4%, but had significantly increased in only 22.6% of patients and remained increased in 21.9% at 1 month.

"There was no difference in dry-eye symptoms between the superior-hinge and temporal-hinge groups at any time point," the authors wrote.

Corneal fluorescein staining of grade 1+ to 2+ was noted in 17% of the superior-hinge group and in 19% of the temporal-hinge group at 1 week postop. No patients had fluorescein staining greater than grade 2, and values for both groups had returned to normal by 1 month follow-up, according to the study.

The study is published in the July issue of Journal of Cataract and Refractive Surgery.