Prevalence of Signs and Symptoms of Dry Eye Disease 5 to 15 After Refractive Surgery
Received 31 October 2019
Accepted for publication 24 December 2019
Published 28 January 2020 Volume 2020:14 Pages 269—279
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Bjørn Gjerdrum,1,2 Kjell Gunnar Gundersen,2 Per Olof Lundmark,1 Rick Potvin,3 Bente Monica Aakre1
1Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway; 2Ifocus Eye Clinic, Haugesund, Norway; 3Science in Vision, Akron, NY, USA
Correspondence: Bjørn Gjerdrum
Brønngata 36, Stavanger 4008, Norway
Tel +47 415 11 935
Purpose: To compare the prevalence of dry eye disease (DED) as determined by signs and symptoms in patients with a history of laser vision correction (LVC) or implantable collamer lens (ICL) implantation 5– 15 years ago with a matched control group with no history of refractive surgery.
Patient and Methods: This was a cross-sectional case-control study. The subject population included patients who had LVC or ICL 5 to 15 years ago. The control group was age matched. A test eye was randomly chosen. Subjects were required to have good ocular health. DED was evaluated using categorical cut-off criteria for tear film osmolarity (measured in both eyes), the subjective Ocular Surface Disease Index (OSDI), the dynamic Objective Scatter Index (OSI), non-invasive keratography tear break-up time (NIKBUT), meibography, and the Schirmer 1 test.
Results: The study included 257 subjects (94 LVC, 80 ICL, 83 control). The frequency of hyperosmolarity was significantly higher in the LVC group vs the control (73% vs 50%, p = 0.002), In contrast, the frequency of subjective symptoms tended to be lower in the LVC group than in the control group (19% vs 31%; p = 0.06). These differences were not seen between the ICL and control group.
Conclusion: The results suggest that LVC may cause tear film instability as indicated by hyperosmolar tears up to 15 years after surgery, with few subjective symptoms of dry eye. This may have implications for IOL calculations for cataract or refractive lens exchange later in life.
Keywords: tear film, hyperosmolarity, OSDI, post LVC
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