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UV protection during LASIK lowers dry eye incidence, surgeon says
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CHICAGO — Dry eye after LASIK may result from ultraviolet light exposure from the excimer laser itself, according to a speaker here, and UV protection during the excimer laser ablation can lower the incidence of post-LASIK dry eye occurrence by 70%.
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Since 1992, more than 150 papers have been written on the subject of dry eye after LASIK, but the problem did not exist prior to the introduction of the excimer laser, Carmen Barraquer, MD, said during the American Society of Cataract and Refractive Surgery meeting.
"In our clinical surgical experience, we have never seen such a syndrome after penetrating grafts, after lamellar grafts, after ... keratomileusis," she said. "What is the difference then between LASIK ... and grafts or refractive procedures before excimer? Well, the most obvious answer is the excimer laser."
Dr. Barraquer hypothesized that the UV light in the laser interacts with oxygen, producing ozone, and "every pulse is associated with an equal area of collateral damage" to the eye.
In order to test her theory, she conducted a randomized, controlled, open label clinical trial in which she performed LASIK on 300 eyes: 150 with the standard procedure and 150 with her protective procedure, which includes Merocel sponge coverage of the limbus area, bulbar conjunctiva, and stromal side of the flap.
Eyes underwent tear break-up and Shirmer's tests preoperatively and 10 days later were examined by separate specialists with the same tests. In the 143 eyes included in the data, 70 received standard treatment and 73 received the protected treatment.
"With the protected technique you have almost 70% less possibility of getting dry eye syndrome and ... females have three times more possibility of having dry eye syndrome" when they receive the standard treatment, she said.