Dry eye after LASIK for myopia: Incidence and risk factors

Abstract

Purpose: Patients frequently experience dry eye symptoms after laser-assisted in situ keratomileusis (LASIK). The purpose of this study was to determine the incidence and risk factors of dry eye after myopic LASIK.

Methods: In this retrospective case series 190 eyes that underwent LASIK were examined for a dry eye syndrome. All patents were asymptomatic for dry eyes before surgery. Assessments included subjective complaints of dry eye, tear break-up time (TBUT), corneal staining, corneal sensitivity test, and Schirmer I test. All values were compared before and at 1 week and 1.3 and 6 months after surgery.

Results: For the 190 eyes, chronic dry eye persisting 6 months or more after LASIK was diagnosed in 20 percent of the eyes. Mean patient age was 31 +/- 8 years. The risk for chronic dry eye was significantly associated with higher attempted refractive correction, greater ablation depth, and female sex (p=0.001). Subjective score for dryness was increased after LASIK. The greatest change from preoperative levels for all parameters was noted at 1 week. There were obvious decreases in TBUT and Schirmer value at 1, 3, and 6 months postoperatively relative to preoperative level (p<0.05). The Schirmer I test result was higher at 1 day but without statistical significance (p>0.05), but lower at 1 week and 3 and 6 months (p<0.05) after LASIK. Corneal sensitivity was decreased at 1 month and 3 months, and returned to the preoperative level at 6 months after LASIK. There was a statistically significant effect of age, sex, and mean spherical equivalent refraction on corneal sensitivity (p<0.001).

Conclusions: Patients undergoing LASIK for myopia develop dry eye with compromised tear function at least 6 months after surgery. Women and patients requiring higher refractive correction have an increased risk for developing dry eye.