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Cartes C, Aravena C, Monsalve A, Segovia C, Romero C, Quidel D, Cid F, Monsalve R, Navarro L, Araya D, Araneda D, Sepulveda M. Prevalence of Dry Eye Disease in Laser-Assisted In Situ Keratomileusis Candidates. Eye Contact Lens 2024; 50:305-310. [PMID: 38918902 DOI: 10.1097/icl.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVE To evaluate the prevalence of dry eye disease (DED) in laser-assisted in situ keratomileusis (LASIK) candidates. METHODS A chart review of consecutive LASIK candidates who underwent full ocular surface work-up was performed, including ocular surface disease index (OSDI), noninvasive tests (noninvasive tear breakup time [ni-TBUT], tear meniscus height, lipid layer thickness, and meibography), and invasive tests (Schirmer test I, fluorescein TBUT, corneal staining, and meibomian gland [MG] expressibility). The prevalence of DED was calculated according to the Dry Eye Workshop II (DEWS II), and Japanese and Asia Dry Eye Society (JDES/ADES) criteria. RESULTS In total, 135 patients (270 eyes) were evaluated. The mean age was 32.6±8.3 years, and 62.9% were women (n=85); 19 patients (15.4%) wore contact lenses, and 31 patients (23.8%) used artificial tears. The mean OSDI was 18.2±16.9, which was abnormal in 54.1% (n=62). Inferior lid MG dropout was the sign with the highest percentage of abnormal results (61.5%; n=83). There were no differences between men and women in any test except for ni-TBUT (6.3±0.3 and 7.2±0.2, respectively; P=0.002). Dry eye disease prevalence was 25.9% and 53.3%, according to JDES/ADES and DEWS II criteria, respectively. The only significant risk factor for DED was artificial tear use for both DEWS II (odds ratio [OR]=3.5, confidence interval [CI] [1.35-9.39]) and JDES/ADES (OR=2.58, CI [1.03-6.48]). CONCLUSIONS This study found a high prevalence of DED and abnormalities in LASIK candidates and highlights the importance of ocular surface evaluation before photorefractive surgery.
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Affiliation(s)
- Cristian Cartes
- Unidad Oftalmología (C.C., C.A., A.M., R.M., L.N.), Departamento de Especialidades, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile; Oftamédica Clinic (C.C., C.R., D.Q., F.C., R.M., L.N., Daniela Araya, Daniela Araneda), Temuco, Chile; Programa de Doctorado en Salud Ecosistémica (C.S.), Centro de Investigación de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca; Laboratorio de Microbiología y Parasitología (C.S.), Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad Católica del Maule, Talca, Chile; and Departamento de Tecnología Médica (M.S.), Facultad de Ciencias de la Salud. Universidad Católica del Maule, Talca, Chile
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Tamimi A, Sheikhzadeh F, Ezabadi SG, Islampanah M, Parhiz P, Fathabadi A, Poudineh M, Khanjani Z, Pourmontaseri H, Orandi S, Mehrabani R, Rahmanian M, Deravi N. Post-LASIK dry eye disease: A comprehensive review of management and current treatment options. Front Med (Lausanne) 2023; 10:1057685. [PMID: 37113611 PMCID: PMC10126282 DOI: 10.3389/fmed.2023.1057685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
Laser-assisted in situ keratomileusis (LASIK) is a unique corneal stromal laser ablation method that uses an excimer laser to reach beneath corneal dome-shaped tissues. In contrast, surface ablation methods, such as photorefractive keratectomy, include removing epithelium and cutting off the Bowman's layer and the stromal tissue of the anterior corneal surface. Dry eye disease (DED) is the most common complication after LASIK. DED is a typical multi-factor disorder of the tear function and ocular surface that occurs when the eyes fail to produce efficient or adequate volumes of tears to moisturize the eyes. DED influences quality of life and visual perception, as symptoms often interfere with daily activities such as reading, writing, or using video display monitors. Generally, DED brings about discomfort, symptoms of visual disturbance, focal or global tear film instability with possible harm to the ocular surface, the increased osmolarity of the tear film, and subacute inflammation of the ocular surface. Almost all patients develop a degree of dryness in the postoperative period. Detection of preoperative DED and committed examination and treatment in the preoperative period, and continuing treatments postoperatively lead to rapid healing, fewer complications, and improved visual outcomes. To improve patient comfort and surgical outcomes, early treatment is required. Therefore, in this study, we aim to comprehensively review studies on the management and current treatment options for post-LASIK DED.
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Affiliation(s)
- Atena Tamimi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sajjad Ghane Ezabadi
- Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Peyman Parhiz
- Student Research Committee, Zahedan Medical Sciences Branch, Islamic Azad University, Zahedan, Iran
| | - Amirhossein Fathabadi
- Student Research Committee, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Khanjani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pourmontaseri
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- Bitab Knowledge Enterprise, Fasa University of Medical Sciences, Fasa, Iran
| | - Shirin Orandi
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Mehrabani
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Rahmanian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Niloofar Deravi,
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Wu Y, Xu L, Song Y, Zhang Q, Qin G, Yang L, Ma J, Palme C, Moore JE, Pazo EE, He W. Management of Post-LASIK Dry Eye with Intense Pulsed Light in Combination with 0.1% Sodium Hyaluronate and Heated Eye Mask. Ophthalmol Ther 2022; 11:161-176. [PMID: 34741758 PMCID: PMC8770788 DOI: 10.1007/s40123-021-00418-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/25/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Laser in situ keratomelieusis (LASIK) is one of the most frequently performed refractive treatments. Dry eye (DE) is common in patients after LASIK and can be bothersome postoperatively. Therapies such as intense pulsed light (IPL), sodium hyaluronate (SH) and heated eye mask (HEM) have been reported to improve signs and symptoms of DE . AIM The purpose of this prospective study was to evaluate and compare the effects of IPL and 0.1% SH (IPL group, 50 eyes) and IPL in combination with 0.1% SH and HEM (IPL + group, 50 eyes) in participants with persistent post-LASIK DE. METHODS The final analysis included 100 patients (100 eyes) who had LASIK for myopic correction and had been experiencing moderate to severe DE following LASIK for over a year. Participants were randomly assigned to either the IPL group (2 IPL sessions) or IPL + group (2 IPL sessions and daily HEM for 4 weeks), and both groups continued the use of daily 0.1% SH (HYLO-COMOD®) preservative-free eye drops. Non-invasive tear break-up time (NITBUT), tear film lipid layer (TFLL), lower tear meniscus height (LTMH), meibomian gland quality (MGQ), meibomian gland expressibility (MGEx), corneal fluorescein staining (CFS), ocular surface disease index (OSDI) and artificial tear usage (ATU) survey were assessed at baseline (BL) and follow-up at 2 (F1) and 4 weeks (F2). RESULTS Following the treatment protocol, all dry eye (DE) parameters assessed in this study improved significantly (P < 0.05) in both groups at F2 compared with their respective BL measurements. Inter-group comparison at F2 found significant differences in their NITBUT (IPL: 6.06 ± 0.59 vs. IPL +: 6.67 ± 0.86, P < 0.001), TFLL (IPL: 1.90 ± 0.65 vs. IPL +: 1.60 ± 0.64, P = 0.021), LTMH (IPL: 0.186 ± 0.053 vs. 0.204 ± 0.034, P = 0.003), MGQ (IPL: 1.48 ± 0.54 vs. IPL +: 1.26 ± 0.56, P = 0.026), MGEx (IPL: 1.62 ± 0.53 vs. IPL +: 1.44 ± 0.50, P = 0.038) and OSDI (IPL: 32.54 ± 6.85 vs. IPL +: 29.76 ± 4.74, P = 0.001), while CFS score (IPL: 4.02 ± 0.65 vs. IPL +: 3.96 ± 0.73, P = 0.652) and ATU (IPL: 1.88 ± 0.63 vs. IPL +: 1.72 ± 0.50, P = 0.159) showed no significant difference. CONCLUSION Post-LASIK DE signs and symptoms can be improved by combining therapies such as IPL, HEM and 0.1% SH. Increased TFLL due to a combination of IPL, 0.1% SH and HEM had a greater positive impact on the subjective and objective DE measurements in participants with persistent post-LASIK DE.
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Affiliation(s)
- Yi Wu
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ling Xu
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
| | - Yilin Song
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qing Zhang
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guanghao Qin
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lanting Yang
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China
- The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jinfei Ma
- Zhejiang University School of Medicine First Affiliated Hospital, Breast Cancer, Hangzhou, Zhejiang, China
| | - Christoph Palme
- Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Emmanuel Eric Pazo
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China.
| | - Wei He
- Department of Ophthalmology, He Eye Specialist Hospital, No. 128 North Huanghe Street, Shenyang, 1100 34, China.
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Recchioni A, Hartwig A, Dermott J, Vaswani S, Bhatt J, Morris R, O’Donnell C. Early clinical outcomes after small incision lenticule extraction surgery (SMILE). Cont Lens Anterior Eye 2018; 41:132-135. [DOI: 10.1016/j.clae.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 11/28/2022]
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Dry Eye Post-Laser-Assisted In Situ Keratomileusis: Major Review and Latest Updates. J Ophthalmol 2018; 2018:4903831. [PMID: 29619255 PMCID: PMC5829349 DOI: 10.1155/2018/4903831] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 12/12/2017] [Indexed: 11/18/2022] Open
Abstract
Dry eye is one of the most common complications occurring after laser-assisted in situ keratomileusis (LASIK), with virtually all patients experiencing some degree of postoperative dry eye symptoms. Enhanced understanding of the pathophysiology and mechanism of dry eye development in addition to preoperative screening of patients who are prone to dry eye is essential for better patient satisfaction and for improving short-term visual outcome postoperatively. This article reviews the latest studies published on LASIK-associated dry eye, including epidemiology, pathophysiology, risk factors, preoperative assessment, and management.
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Katara R, Sachdeva S, Majumdar DK. Aceclofenac oil drops: characterization and evaluation against ocular inflammation. Pharm Dev Technol 2017; 23:240-246. [DOI: 10.1080/10837450.2017.1337794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Rajesh Katara
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research (Formerly College of Pharmacy), University of Delhi, New Delhi, India
| | - Sameer Sachdeva
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research (Formerly College of Pharmacy), University of Delhi, New Delhi, India
- Amneal Pharmaceuticals, Piscataway, NJ, USA
| | - Dipak K. Majumdar
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research (Formerly College of Pharmacy), University of Delhi, New Delhi, India
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Moshirfar M, Jehangir N, Fenzl CR, McCaughey M. LASIK Enhancement: Clinical and Surgical Management. J Refract Surg 2017; 33:116-127. [DOI: 10.3928/1081597x-20161202-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/26/2016] [Indexed: 11/20/2022]
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Son DY, Hwang S, Hyun J, Lim DH, Chung ES, Chung TY. Prevalence and Risk Factors of Dry Eye Disease after Refractive Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.7.782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dae Yong Son
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungsoon Hwang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Hyun
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Saevit Eye Center, Goyang, Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eui Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Rhee's Eye Hospital, Daejeon, Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Shaheen BS, Bakir M, Jain S. Corneal nerves in health and disease. Surv Ophthalmol 2014; 59:263-85. [PMID: 24461367 PMCID: PMC4004679 DOI: 10.1016/j.survophthal.2013.09.002] [Citation(s) in RCA: 305] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 08/23/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022]
Abstract
Corneal nerves are responsible for the sensations of touch, pain, and temperature and play an important role in the blink reflex, wound healing, and tear production and secretion. Corneal nerve dysfunction is a frequent feature of diseases that cause opacities and result in corneal blindness. Corneal opacities rank as the second most frequent cause of blindness. Technological advances in in vivo corneal nerve imaging, such as optical coherence tomography and confocal scanning, have generated new knowledge regarding the phenomenological events that occur during reinnervation of the cornea following disease, injury, or surgery. The recent availability of transgenic neurofluorescent murine models has stimulated the search for molecular modulators of corneal nerve regeneration. New evidence suggests that neuroregenerative and inflammatory pathways in the cornea are intertwined. Evidence-based treatment of neurotrophic corneal diseases includes using neuroregenerative (blood component-based and neurotrophic factors), neuroprotective, and ensconcing (bandage contact lens and amniotic membrane) strategies and avoiding anti-inflammatory therapies, such as cyclosporine and corticosteroids.
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Affiliation(s)
- Brittany Simmons Shaheen
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - May Bakir
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Sandeep Jain
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois.
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Tong L, Zhao Y, Lee R. Corneal refractive surgery-related dry eye: risk factors and management. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.2013.851602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Clinical Effectiveness of Topical Cyclosporine A 0.05% After Laser Epithelial Keratomileusis. Cornea 2013; 32:e150-5. [DOI: 10.1097/ico.0b013e31829100e5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Enhanced Screening for Ectasia Susceptibility Among Refractive Candidates: The Role of Corneal Tomography and Biomechanics. CURRENT OPHTHALMOLOGY REPORTS 2013. [DOI: 10.1007/s40135-012-0003-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Benelli U. Systane lubricant eye drops in the management of ocular dryness. Clin Ophthalmol 2011; 5:783-90. [PMID: 21750611 PMCID: PMC3130915 DOI: 10.2147/opth.s13773] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Indexed: 11/23/2022] Open
Abstract
The understanding of dry eye disease has advanced recently through increasing recognition that the etiology of the condition involves both tear evaporation and insufficient tear production, and that tear film instability and inflammation play roles in the various stages of the disease. Of significance, it has been recognized that lipid layer thickness correlates with tear film stability. The management of dry eye involves various strategies and therapeutic approaches that address one or more etiopathological components of the disease. The purpose of this review is to outline the characteristics and clinical utility of the Systane(®) ocular lubricants that contain hydroxypropyl-guar and one or both of the demulcents, ie, polyethylene glycol 400 and propylene glycol. Clinically, these products are safe and are indicated for the temporary relief of burning and irritation due to dryness of the eye. In particular, this review describes the formulations, mechanisms of action, and clinical utility of the newest additions to this topical ocular lubricant family, Systane Ultra(®) and Systane Balance(®). Both of these ocular products are formulated with an intelligent delivery system and both provide symptomatic relief to patients with dry eye. However, Systane Balance is a novel formulation that contains both polymer and lipid components designed to protect the ocular surface and replenish tear film lipids simultaneously, a factor that is of particular relevance to patients who have dry eye associated with meibomian gland dysfunction.
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Affiliation(s)
- Umberto Benelli
- Department of Neurosciences, Section of Ophthalmology, University of Pisa, Pisa, Italy
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Hur MC, Kwon YH, Rho SH. The Changes in Tear Film and Corneal Sensation after Refractive LASIK Surgery for Presbyopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2011. [DOI: 10.3341/jkos.2011.52.12.1419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mun Chong Hur
- Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
| | | | - Sae Heun Rho
- Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
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Corneal refractive therapy gas permeable lenses for the correction of hyperopia after one night of lens wear. Eye Contact Lens 2010; 37:26-30. [PMID: 21178697 DOI: 10.1097/icl.0b013e3182048fd1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine the refractive and keratometric response of corneal refractive therapy (CRT) contact lenses for hyperopia (CRT) after a single night of contact lens wear with the goal of reducing hyperopia by +3.50 D. METHOD Twenty participants were fitted with a CRT HDS 100 contact lens, in one eye only. The back optic zone radius of the CRT lens was designed to correct 3.50 D of hyperopia. The eyes were randomly selected. The Nikon Auto Refractor was used to measure refractive error. Corneal topography and simulated K readings were measured using the Humphrey Atlas topographer. The lens was subsequently worn overnight, and the lens was assessed the next morning on awakening. RESULTS Refractive error changed by 1.50±0.71 D (mean ± SD, range 0.50-2.75 D) immediately after lens removal in the experimental eye. Similarly, there was a change in flat K readings of 0.58±0.62 D with a range of -0.25 to +1.87 D. These results were significantly different from the baseline measurements (P<0.0001). CONCLUSIONS The fitting of CRT HDS for hyperopia has a significant effect on corneal shape and refractive error. There was a moderate yet significant steepening of the cornea.
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