Howard Larkin

Posted: Wednesday, January 10, 2018

Against expectations, a new study of post-LASIK dry eye found that the patient-reported severity of symptoms decreased, rather than increased, with age, Julie M Schallhorn MD told Refractive Surgery Day at the 2016 American Academy of Ophthalmology Annual Meeting in Chicago.

“This goes against our conventional wisdom,” said Dr Schallhorn, of the University of California, San Francisco, USA. The study also found that both the frequency and severity of dry symptoms increased after surgery. While women reported dry eye more often and of greater severity than men, the increases after surgery were similar for both genders and across age groups.

This retrospective, comparative study examined outcomes of 12,390 patients including 24,099 eyes that underwent primary LASIK at a large refractive surgery provider based in the UK between 1 January 2014 and 1 September 2016. Patients completed a questionnaire preoperatively and three months after LASIK surgery, asking how often they had dry eye symptoms, and how much difficulty this created, judged on a seven point scale, in the previous week.

Before surgery, about 70% of men and 60% of women reported no dry eye symptoms in the previous week. Of those who did report symptoms, most said they had them “some of the time”, with about 4% of women and 3% of men saying half the time, and about 2% of women and 1% of men saying most or all of the time.

Similarly, about 71% of men and 63% of women said they had no difficulty with symptoms, while most who did report difficulty rated it moderate or less, and about 1% rated them worse than moderate. Mean frequency of dry eye symptoms was similar across all age groups. However, symptom severity declined after age 40 for women and men.

Three month after surgery, both women and men reported an increase in frequency and severity of dry eye symptoms. Only about 45% of men and 40% of women said they had no difficulty with dry eye symptoms, while about half reported moderate difficulty or less, and about 5% reported worse than moderate severity. Frequency of dry eye symptoms after surgery increased with age until the fifth decade of life, and decreased among older patients. Change in dry eye severity after surgery was not influenced by age, Dr Schallhorn reported.
Julie M Schallhorn:

ESCRS Posters

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  • Poster: Cyclosporine A in the treatment of patients with severe dry eye

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  • Poster: The role of multifocal IOL choice in refractive lens replacement

  • Poster: Analysis of postoperative alignment error of toric intraocular lenses by ray-tracing aberrometry and slit lamp, and its correlation with visual outcome

  • Poster: Efficacy and safety of lifitegrast ophthalmic solution 5.0% in three randomized controlled trials for dry eye disease