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Comparing Dry Eye Disease After Small Incision Lenticule Extraction and Laser Subepithelial Keratomileusis.

AbstractPURPOSE:
To compare dry eye disease parameters between small incision lenticule extraction (SMILE) and laser subepithelial keratomileusis (LASEK).
METHODS:
This prospective, nonrandomized study included 39 eyes of 39 patients who underwent SMILE (n = 19) and LASEK (n = 20). Dry eye disease parameters included Ocular Surface Disease Index (OSDI), tear breakup time, Schirmer I test (SIT) value, corneal esthesiometry result, tear meniscus area, meibomian gland evaluation result, lipid layer thickness, and blink rate. Evaluations were performed before surgery and at 1 and 6 months after surgery.
RESULTS:
Compared with the LASEK group, the SMILE group showed lower corneal esthesiometry values at 1 month and higher OSDI scores and lower SIT values at 6 months after surgery. The SMILE group showed significantly higher OSDI scores at 1 and 6 months after surgery than before, but significantly lower OSDI scores at 6 months than at 1 month after surgery. Both groups showed significantly decreased corneal sensitivity at 1 month after surgery, which increased to the preoperative level 6 months after surgery. The change in OSDI scores at 1 month after surgery positively correlated with changes in the total and partial blink rates, whereas the change in corneal sensitivity at 1 month after surgery negatively correlated with the total and partial blink rates.
CONCLUSIONS:
Both SMILE and LASEK groups showed temporary decreases in corneal sensitivity, which recovered to baseline levels. Although subjective symptoms worsened after SMILE, SIT values improved after LASEK. Compared with SMILE, LASEK yielded better results regarding subjective symptoms, tear production, and corneal sensitivity.
AuthorsByunghoon Chung, Moonjung Choi, Keun Young Lee, Eung Kweon Kim, Kyoung Yul Seo, Ikhyun Jun, Kang Yoon Kim, Tae-Im Kim
JournalCornea (Cornea) Vol. 39 Issue 4 Pg. 501-507 (Apr 2020) ISSN: 1536-4798 [Electronic] United States
PMID31868850 (Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)
Topics
  • Adult
  • Corneal Stroma (surgery)
  • Female
  • Follow-Up Studies
  • Humans
  • Keratectomy, Subepithelial, Laser-Assisted (methods)
  • Lasers, Excimer (therapeutic use)
  • Male
  • Myopia (physiopathology, surgery)
  • Prospective Studies
  • Visual Acuity
  • Young Adult

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