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Patient reported dry eye symptoms challenge previous thinking

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SAN DIEGO — Many conceptions about dry eye and LASIK can be challenged by data, according to a speaker.

For example, dry eye before surgery does not necessarily mean dry eye after surgery,” Julie M. Schallhorn, MD, MS, told colleagues at Refractive Subspecialty Day at the American Society of Cataract and Refractive Surgery annual meeting.

“There’s a dogma that’s associated with [LASIK] – things that we learned and we believe – that when you start looking at the data don’t hold up to inspection,” she said.

Schallhorn and colleagues undertook a population-based study of all refractive surgery patients over a 2-year period who completed a confidential questionnaire preoperatively and 3 months postoperatively.

Dry eye symptoms were reported by 41.5% of patients before surgery. Women were 23 times more likely to report preoperative dry eye than men, and contact lens wearers were 45 times more likely to report symptoms than non-contact lens users.

“Patients who reported more severe dry eye before surgery on average tended to report less dry eye after surgery,” Schallhorn said. “This was a linear correlation across all levels of dry eye. From the mild dry eye patients to the severe dry eye patients, they tended to get better after surgery.”

Whether dry eye in women is worse after LASIK, Schallhorn said gender plays a very small clinical role, with women reporting 1.7% greater symptoms than men.

Whether patients with dry eye should undergo PRK instead of LASIK, Schallhorn said, in the short-term, more PRK patients than LASIK patients reported symptoms A total of 1,841 patients underwent PRK and 11,487 underwent LASIK with no difference between percentages of patients reporting dry eye symptoms before surgery. At 3 months, 4% more PRK patients reported dry eye symptoms than did LASIK patients. – by Patricia Nale, ELS

Reference: Schallhorn J. Challenging conventional wisdom about LASIK. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 3-7, 2019; San Diego. Disclosure: Schallhorn reports she is a consultant for Zeiss, Johnson & Johnson and Avedro.