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LASIK and LASEK yield similar dry eye disease markers, tear osmolarity up to 1 year
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Patients who underwent LASIK and LASEK had similar dry eye disease markers and tear osmolarity up to 1 year postoperatively, a study found.
“There were no significant differences in dry-eye disease markers or tear osmolarity between LASIK or LASEK at any stage after surgery up to 1 year,” the study authors said. “Although both groups of patients used more topical lubricants 3 months and 6 months postoperatively, the need for lubricants was reduced to baseline by 12 months. There was no significant deterioration in dry-eye parameters with LASEK or LASIK at any point.”
The prospective study included 85 eyes of 85 patients; 50 eyes underwent LASIK and 35 eyes underwent LASEK. Mean follow-up was 7.2 ± 8.2 months in the LASIK group and 9.1 ± 9.7 months in the LASEK group.
Dry eye disease markers were assessed preoperatively and 3 months, 6 months and 12 months after surgery. The TearLab Osmolarity System was used to measure tear osmolarity. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess dry eye symptoms. Schirmer II testing was also performed.
Study results showed that mean tear osmolarity increased by 2.8% in the LASIK group at 12 months; the increase was statistically significant (P = .009). Mean tear osmolarity increased insignificantly at 3 months, 6 months and 12 months in the LASEK group.
Neither group had significant changes in mean Schirmer scores.
Between-group differences in mean OSDI were insignificant at baseline, 3 months, 6 months and 12 months, the authors said.
Perspective
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Eric D. Donnenfeld, MD
This study compares the effect of LASIK vs. LASEK on tear osmolarity and dry eye symptoms for up to 1 year postoperatively. The major limitation of the study was the ability of the patients to select which group they were part of and a significant difference in the age of the patients enrolled. In addition, no mention of flap diameter is considered. However, the finding of no significant difference between the LASIK and LASEK in tear osmolarity and symptoms at 1 year is important. Dry eye is the most common complaint following corneal refractive surgery and the use of smaller, thinner flaps has dramatically reduced this problem to the point that there is no significant difference in dry eye following LASIK and surface ablation.
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J Cataract Refract Surg. 2012;38(6):1058-1064.
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