Sodium chloride pretreatment may decrease risk of epithelial disruption during LASIK

Pretreatment with a hyperosmotic agent before LASIK may lower the incidence of epithelial disturbances and decrease postoperative complications for high-risk patients, according to a study.

The comparative case series evaluated 248 patients who had bilateral LASIK after randomized hyperosmotic treatment of sodium chloride 5% ointment in one eye of each patient. The degree of epithelial disruption was indicated by an epithelial integrity score ranging from grade 1 (no disruption) to grade 4 (frank epithelial defect with surface loss).

The untreated control group had a 40% higher chance of having an epithelial integrity score of grade 2 or higher compared with the treated group.

Among the characteristic-based subgroups, age was the best predictor of corneal epithelial disruptions, with a 9% increase of risk for every 1 year of increased age. Patients older than 34 years of age had a 4.4-fold increased risk for intraoperative epithelial disruptions vs. those younger than 34 years old.

“If a hyperosmotic agent can alter the result of an adhesion test by creating tighter adhesion of the epithelium to its basement membrane, the population of good candidates for LASIK might be expanded,” the study authors said. – by Kristie L. Kahl

Disclosure: The authors report no relevant financial disclosures.

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Source:

Holzman A, et al. J Cataract Refract Surg. 2015;doi:10.1016/j.jcrs.2014.07.042.