Received: 08.09.2022; Accepted: 29.09.2022; Published on-line: 27.10.2022
Assessing the early and late impact of excimer laser correction for myopia on the development of dry eye syndrome
S. Yu. Mogilevskyy, M. Yu. Zhovtoshtan
Shupik National Healthcare University of Ukraine; Kyiv (Ukraine)
TO CITE THIS ARTICLE: Mogilevskyy SYu, Zhovtoshtan MYu. Assessing the early and late impact of excimer laser correction for myopia on the development of dry eye syndrome. J.ophthalmol.(Ukraine).2022;5:23-9. http://doi.org/10.31288/oftalmolzh202252329
Background: Today, the global annual volume of excimer laser correction (ELC) is estimated to be 3.6 million procedures. Dry eye syndrome (DES) is a complication of ELC for myopia, and the frequency of DES at 1 month and 6 months after ELC for myopia has been reported to be 60% and 20%, respectively.
Purpose: To assess the early and late impact of ELC for myopia on the development of DES.
Material and Methods: Sixty-eight myopic patients (136 eyes) were prospectively divided into two groups, group 1 (a Laser-Assisted in Situ Keratomileusis (LASIK) group) and group 2 (a FemtoLASIK group). Patient age ranged from 20 to 44 years. Patients were assessed for DES (ocular surface, tear production, and tear film stability) preoperatively and postoperatively. Patients of group 1 received thin-flap LASIK using the Alcon Wavelight EX500 excimer laser. A 110-µm corneal flap was created by a Carriazo-Pendular microkeratome in group 1 and by an Alcon FS200 femto laser in group 2. Follow-up duration was 12 months.
Results: Preoperative function tests showed mild dry eye in some patients of both groups. At 1 month and 3 months after ELC, the frequency of DES increased in group 1 by 75.5% and 63%, respectively, and in group 2, by 76.5% and 64.9%, respectively. At 6 months, the frequency of DES decreased in groups 1 and 2 by 38.7% and 40%, respectively, compared to the 3-month time point. However, 10% of the patients showing no signs of DES preoperatively had persistent DES after ELC.
Conclusion: First, the baseline frequency of DES in patients with myopia was 10%. Second, at 1 month and 3 months after ELC for myopia, the frequency of DES increased by 75.5% and 63%, respectively, in the LASIK group, and by 76.5% and 64.9%, respectively, in the FemtoLASIK group. In addition, the frequency did not depend on the laser technique. Third, we noted a gradual decrease in the frequency of DES at late time points after ELC for myopia. At 6 months, the frequency of DES decreased by 38.7% and 40% in groups 1 and 2, respectively, compared to the 3-month time point. Finally, 10% of the patients showing no signs of DES preoperatively had persistent DES after ELC for myopia.
Keywords: myopia, excimer laser correction, dry eye syndrome
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Corresponding Author: M. Yu. Zhovtoshtan, Email: firstname.lastname@example.org
Author Contribution: Mogilevskyy S.Yu.: Conceptualization; Writing – review & editing; Zhovtoshtan M.Yu.: Methodology; Writing – review & editing. All authors analyzed the results and the final version of the manuscript was approved by all authors prior to submission.
Funding sources: No external funding sources were used for this study
Conflict of interest: The authors declare that they have no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Study Participants: Informed consent was obtained from all participants. Approval for the study was obtained from the Bioethics Committee, the Shupik National Healthcare University of Ukraine. The procedures followed were in accordance with the ethical standards of the Helsinki Declaration of the World Medical Association, European Convention on Human Rights and Biomedicine (1977), relevant provisions of WHO’s Constitution, Council for International Organizations of Medical Science, International Code of Medical Ethics (1983), and Ministry of Health Order No. 690, dated 23 September, 2009.
Abbreviations: DES, dry eye syndrome; ELC, excimer laser correction; FDA, Food and Drug Administration; FS, femtosecond laser; LASIK, Laser-Assisted in Situ Keratomileusis; PRK, Photorefractive Keratectomy