Effect of Gender and Procedure on Patient-Reported Dry Eye Symptoms After Laser Vision Correction

Abstract

Purpose: To evaluate factors associated with the change in dry eye symptoms following laser vision correction.

Methods: This was a retrospective case series of 13,319 patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2013 and February 2016 and completed a preoperative and 3-month postoperative patient-reported outcome questionnaire.

Results: In a multivariate linear regression model, women and contact lens wearers were associated with worse preoperative dry eye symptoms. Age was not significantly associated with preoperative dry eye symptoms. The change in dry eye symptoms preoperatively to postoperatively was affected by gender, procedure type, and preoperative dry eye symptoms. Patients who underwent PRK were more likely to report an increase in dry eye after 3 months (coefficient: 3.99, 95% confidence interval (CI): 1.64 to 4.82, P < .001) and patients with worse preoperative dry eye were more likely to have improvement in symptoms after surgery (coefficient: -0.93, 95% CI: -0.97 to -0.90, P < .001). More women reported an increased level of symptoms 3 months after surgery than men (coefficient: 1.76, 95% CI: 0.68 to 2.84, P = .001).

Conclusions: Preoperative dry eye symptoms, female gender, and procedure type had a significant effect on preoperative to postoperative change in dry eye symptoms after laser vision correction. Age was not associated with dry eye symptoms in this population. [J Refract Surg. 2019;35(3):161-168.].

Figure 1.

Relationship between age, gender, and preoperative dry eye score. The scattergram shows the mean preoperative composite dry eye score in 2-year age intervals for men and women. The solid line (men) and dashed line (women) represent the linear regression.

Figure 2.

Relationship between the preoperative dry eye composite score and the change in the preoperative to postoperative dry eye score. Each marker represents the average change from preoperative to postoperative for patients with the corresponding preoperative composite score. The line is the linear regression for the correlation between the preoperative composite dry eye score and the change from preoperative to postoperative for all patients.