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Laser-Assisted In Situ Keratomileusis for Patients With Dry Eye
Ikuko Toda, MD;
Naoko Asano-Kato, MD;
Yoshiko Hori-Komai, MD;
Kazuo Tsubota, MD
Arch Ophthalmol. 2002;120:1024-1028.
Objective To evaluate the efficacy and safety of laser-assisted in situ keratomileusis
(LASIK) in patients with preoperative dry eye.
Methods We divided the 543 eyes that underwent LASIK into the following 3 groups:
eyes with definite dry eye (DE group), with probable dry eye (PDE group),
and without dry eye (NDE group). We evaluated visual outcome, dry-eye status,
and complications.
Outcome Measures We compared uncorrected and best-corrected visual acuity, manifest refraction,
symptoms, tear function, ocular surface abnormality, complications, corneal
sensitivity, endothelial cell count, and patient satisfaction among the groups.
Results We found no significant differences among the groups in uncorrected
and best-corrected visual acuity, manifest refraction, and patient satisfaction.
A dry-eye symptom, dryness, was more severe in the DE than the NDE group after
LASIK. The mean results of the Schirmer test with anesthesia and tear breakup
times were significantly lower and the fluorescein score was higher in the
DE than the NDE groups after LASIK. We found no differences in the incidence
of complications among the groups. Corneal sensitivity was recovered within
6 months after LASIK in the DE and PDE groups and within 3 months in the NDE
group.
Conclusions The efficacy and safety of LASIK were not affected by preexisting dry
eye. However, preexisting dry eye is a risk factor for severe postoperative
dry eye with lower tear function, more vital staining of the ocular surface,
and more severe symptoms.
From the Minamiaoyama Eye Clinic, Tokyo, Japan (Drs Toda, Asano-Kato,
Hori-Komai, and Tsubota); and the Department of Ophthalmology, Tokyo Dental
College, Chiba, Japan (Dr Tsubota).
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