Dry eye after laser in situ keratomileusis with femtosecond laser and mechanical keratome

Golas, Liliya; Manche, Edward E.

doi:10.1016/j.jcrs.2011.03.035

Cited by 58 publications

(42 citation statements)

References 20 publications

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“…The total number of dissatisfied participants in the PROWL studies was too small to assess associations with other factors. Similar to other studies, 9,11,12,21,42,48 we found that lower satisfaction with vision and surgery was often associated with worse dry eye and visual symptom scores and the use of corrective lenses. To better understand which patients are more likely to be dissatisfied postoperatively, a large observational study, including participants with long-term follow-up after LASIK surgery, would be necessary to accurately estimate the prevalence and find useful predictors for these perceptions.…”

Section: Discussionsupporting

confidence: 90%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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IMPORTANCE Patient-reported outcomes should be collected using validated questionnaires prior to and following laser in situ keratomileusis (LASIK) surgery.OBJECTIVE To report the frequency of patient-reported visual symptoms, dry eye symptoms, satisfaction with vision, and satisfaction with LASIK surgery in the Patient-Reported Outcomes With LASIK (PROWL) studies. DESIGN, SETTING, AND PARTICIPANTSThe PROWL-1 and PROWL-2 studies were prospective, observational studies conducted from September 13, 2011, to June 27, 2014. The PROWL-1 study was a single-military center study of 262 active-duty Navy personnel 21 to 52 years of age. The PROWL-2 study was a study of 312 civilians 21 to 57 years of age conducted at 5 private practice and academic centers. The LASIK surgery and the postoperative care were performed based on the usual practice and clinical judgment at the site. Participants completed a self-administered, web-based questionnaire, preoperatively and postoperatively at 1 and 3 months (the PROWL-1 and -2 studies) and at 6 months (the PROWL-2 study).EXPOSURES Participants underwent LASIK surgery for myopia, hyperopia, and/or astigmatism. MAIN OUTCOMES AND MEASURESVisual symptoms (double images, glare, halos, and/or starbursts), dry eye symptoms, participant satisfaction (with vision and LASIK surgery), and clinical measures (visual acuity, refractive error, and slitlamp and posterior segment eye examination findings) were assessed preoperatively and at 1, 3, and 6 months postoperatively.RESULTS A total of 262 participants were enrolled in the PROWL-1 study (mean [SD] age, 29.1 [6.1] years), and a total of 312 participants were enrolled in the PROWL-2 study (mean [SD] age, 31.5 [7.3] years). Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months). The percentages of participants in the PROWL-1 study with normal Ocular Surface Disease Index scores were 55% (95% CI, 48%-61%) at baseline, 66% (95% CI, 59%-72%) at 3 months, and 73% (95% CI, 67%-79%) at 6 months. The percentages of participants in the PROWL-2 study with normal Ocular Surface Disease Index scores were 44% (95% CI, 38%-50%) at baseline and 65% (95% CI, 59%-71%) at 3 months. Of those participants who had normal scores at baseline in both the PROWL-1 and -2 studies, about 28% (95% CI, 19%-37%) had mild, moderate, or severe dry eye symptoms at 3 months. While most participants were satisfied, the rates of dissatisfaction with vision ranged from 1% (95% CI, 0%-4%) to 4% (95% CI, 2%-7%), and the rates of dissatisfaction with surgery ranged from 1% (95% CI, 0%-4%) to 2% (95% CI, 1%-5%). CONCLUSIONS AND RELEVANCEThe systematic administration of a questionnaire to patients who have undergone LASIK surgery is a new approach to assess symptoms and satisfaction. Our findi...

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Section: Discussionsupporting

confidence: 90%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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“…1,9 The incidence of corneal punctate epithelial keratopathy, as determined by slit-lamp drawing, was significantly higher in the microkeratome group than in the femtosecond group 6 ; however, no significant difference between the two groups in dry eye symptoms was found according to the dry eye questionnaire. 10 The surgical technologies of both methods have improved, and the incidence of corneal punctate epithelial keratopathy has decreased in a similar fashion. In our study, no patients showed significant corneal staining or reported significant sensation of dryness after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, theoretically, the femtosecond laser may be less invasive for the anterior corneal stroma and nerve endings. 6,10 Salomão et al 6 found that the incidence of LASIK-associated dry eye was significantly higher in the microkeratome group (46%) than in the femtosecond group (8%). However, there are several differences between their study and ours.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, whether the femtosecond laser reduces the incidence or decreases the severity of dry eye symptoms compared with the microkeratome is controversial. 6,9,10 Traditional dry eye evaluations, such as a dry eye questionnaire, Schirmer test, tear breakup time, and corneal fluorescein staining, which exhibit fairly good reliability in clinics, have been widely applied in previous studies 6,[10][11][12][13][14] ; however, the conflicting results of these evaluations have been yielded because many factors exist that can influence the outcomes of these evaluations. [15][16][17][18][19] The tear meniscus holds approximately 75% to 90% of the total tears 20 and has been suggested as a useful measure in monitoring the tear volume.…”

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confidence: 99%

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Tear Menisci After Laser In Situ Keratomileusis With Mechanical Microkeratome and Femtosecond Laser

Xie

Zhang

Chen

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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L. Tear menisci after laser in situ keratomileusis with mechanical microkeratome and femtosecond laser. Invest Ophthalmol Vis Sci. 2014;55:5806-5812. DOI:10.1167/ iovs.13-13669 PURPOSE. To investigate the effect on tear menisci after laser in situ keratomileusis (LASIK) with flap creation by either microkeratome or femtosecond laser.METHODS. Sixty eyes of 30 myopes were analyzed. Fifteen patients underwent LASIK with Moria II microkeratome, and the other 15 patients with 60-KHz IntraLase femtosecond laser. Upper and lower tear meniscus parameters of height (UTMH, LTMH) and area (UTMA, LTMA) were measured by SD-OCT preoperatively and 1 week, 1 month, and 3 months postoperatively.RESULTS. Compared with the baseline values, all tear meniscus parameters decreased significantly at each postoperative time point (all P < 0.01) in both groups. LTMH increased significantly between 1 week and 1 month and between 1 and 3 months after surgery in the microkeratome (both P < 0.01) and femtosecond laser groups (P < 0.01, P ¼ 0.012, respectively). There were significant increases in LTMA between 1 week and 1 month after surgery in the microkeratome group (P < 0.01) and in the femtosecond laser group (P ¼ 0.028). There were no significant differences in UTMH, UTMA, LTMH, or LTMA between two groups. The depth of ablation was negatively correlated with the LTMA at 1 week after surgery (R ¼ À0.256, P ¼ 0.049) for all patients.CONCLUSIONS. There were no significant differences in the tear meniscus parameters between the microkeratome and femtosecond laser groups. The depth of ablation was significantly correlated with the LTMA only at 1 week after surgery.

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“…Кроме того, в группе IntraLase гораздо меньшему количеству пациентов требуется назначение циклоспорина местного действия. Однако, в рандомизированном клиническом исследовании Golas и соавт., выполненном на 51 пациенте [25] через 1, 3, 6 и 12 месяцев после LASIK статистически достоверной разницы в симптомах «сухого глаза» выявлено не было.…”

Section: осложнения после Lasikunclassified

Femtosecond laser in corneal surgery

Mamikonjan¹,

Karamjan²,

Труфанов³

et al. 2018

Medicina

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Dry eye after laser in situ keratomileusis with femtosecond laser and mechanical keratome

Abstract: There appeared to be no statistically significant difference in self-reported dry-eye symptoms between the mechanical keratome group and the femtosecond laser keratome group.

Cited by 58 publications

References 20 publications

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

Tear Menisci After Laser In Situ Keratomileusis With Mechanical Microkeratome and Femtosecond Laser

Femtosecond laser in corneal surgery

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