A retrospective analysis of dry eye interventions during the first postoperative year of patients undergoing LASIK versus PRK
Ribeiro, Pamela Bastos
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INTRODUCTION: There are two main procedures responsible for correcting refractive error: laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). The most common postoperative complication of all laser vision correction (LVC) surgeries is keratoconjunctivitis sicca, or dry eye. In addition to physical irritation, dry eye can cause poor visual acuity and reduced quality of life. There are inconsistencies in the literature about which procedure results in higher rates of dry eye thus we explored the likelihood of a dry eye intervention within the first year after surgery. METHODS: Performing a retrospective chart review of all patients who underwent LVC procedures between 2009-2019 at a private Boston ophthalmology clinic, we were able to quantify the proportion of patients that required postoperative dry eye interventions within the 12 months following surgery. At this clinic, a dry eye intervention was defined as one of two treatments: punctal plug insertion or prescription medication (Restasis or Xiidra) use. RESULTS: A total of 11,175 LASIK eyes from 5,920 individuals, 1,549 LASEK eyes from 880 individuals, and 2,006 PRK eyes from 1,165 individuals were included in the analysis. Comparing the proportion of LASIK dry eye interventions to the proportion of PRK/LASEK dry eye interventions via a 2-sample z-test at an alpha level of significance of 0.05, yielded a z-value= 5.7 and a p-value= <0.0001 at a 95% CI (0.0102 - 0.0208). CONCLUSION: Our results suggest a greater incidence of postoperative dry eye interventions for PRK/LASEK patients compared to LASIK patients in the 12 months following LVC surgery. This study was limited in regards to both objective and subjective indicators of dryness; therefore future studies should attempt to be more comprehensive in evaluating postoperative dry eye. However, this study should help surgeons in the decision making process of which refractive eye surgery to recommend in order to reduce postoperative dry eye incidence and improve overall patient quality of life and satisfaction.
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