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Post-LASIK, PRK change in dry eye symptoms linked to gender, wearing contacts
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Female gender as well as preoperative dry eye symptoms and procedure type all had a significant effect on dry eye patients’ symptoms after either LASIK or PRK.
Additionally, researchers found that patient age was not associated with a change in dry eye symptoms after either procedure, according to a study published in the Journal of Refractive Surgery.
“Patients do not present to clinics after undergoing refractive surgery complaining of corneal epitheliopathy, but they do complain of a persistent sensation of dryness,” the authors wrote. “Patient-reported dry eye symptoms, not clinical findings, are what affect patients in their day-to-day life, and the patient experience of ocular dryness is a major concern for potential refractive surgery patients.”
In this retrospective study, researchers analyzed the data of 13,319 patients who underwent either LASIK or PRK between January 2013 and February 2016. Each patient completed a preoperative and 3-month postoperative outcome questionnaire.
Researchers found that contact lens wear and female gender were associated with worse preoperative dry eye symptoms, with no relationship to age of the patient. Additionally, patients who received PRK had a higher incidence of self-reported increase in dry eye symptoms 3 months postoperatively.
“We found no correlation between the preoperative refractive error and change in dry eye symptoms,” the authors wrote. “[A] sensitivity analysis looking specifically at the amount of intended correction in myopic eyes found no correlation. We can conclude that deeper ablations do not induce more dry eye symptoms in our cohort.”
Lastly, researchers found that dry eye patients with worse preoperative symptoms showed an increased likelihood in symptom improvement 3 months after LASIK or PRK, but the size of the improvements were small.
“Patients who underwent PRK were more likely to report an increase in dry eye symptoms at the 3-month follow-up,” the authors wrote. “Given the relatively short follow-up period, it is possible that differences between the two procedures could disappear at later times.” – by Scott Buzby
Disclosure: Julie Schallhorn reported no relevant financial disclosures. Please see the full study for all other authors’ disclosures.
Perspective
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Justin Kwan, OD, FAAO
Dry eye is a common complaint after refractive surgery, causing discomfort and decreased quality of vision, reducing patient satisfaction with the procedure. This study looked at the effect of gender, age and procedure on dry eye symptoms after refractive surgery.
Preoperatively, women and contact lens wearers had more symptoms of dry eye. Postoperatively, there was an overall increase in dry eye frequency and severity at the 3-month mark, with women and people who had PRK having the largest increase in dry eye symptoms. Interestingly, those who had moderate to severe dry eye before the study did not show an increase in symptoms after the procedure. The authors postulate that those patients were assiduous about using lubricants after surgery.
The study did not look beyond the 3-month mark and did not add to the literature in predicting who will and will not have symptoms after refractive surgery. But it does support the necessity of good counseling prior to surgery as well as the need for patients to use lubricants regularly, particularly women, those who have worn contact lenses and those who undergo PRK.
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