Effect of hinge position on corneal sensation and dry eye after laser in situ keratomileusis using a femtosecond laser.

PURPOSE

To determine whether hinge position has an effect on corneal sensation and dry-eye symptoms after myopic laser in situ keratomileusis (LASIK) performed with the IntraLase femtosecond laser (IntraLase Corp.).

SETTING

University-based academic practice, Ann Arbor, Michigan, USA.

METHODS

Sixty-six consecutive eyes of 33 patients were prospectively evaluated in a randomized contralateral-eye study to compare the difference between superior-hinge and temporal-hinge locations after bilateral myopic LASIK with the IntraLase femtosecond laser. Central Cochet-Bonnet esthesiometry, the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer test with anesthesia, tear breakup time (TBUT), corneal fluorescein, and conjunctival lissamine green staining were evaluated preoperatively as well as 1 week and 1, 3, 6, and 12 months after surgery.

RESULTS

Corneal sensation was reduced with both superior-hinged and temporal-hinged LASIK flaps 1 week and 1, 3, 6, and 12 months after surgery (P<.0001). There was no difference in corneal sensation between superior-hinged and temporal-hinged flaps at any time point. The OSDI score was increased in 22.6% of patients at 1 week and 21.9% at 1 month (P<.00001), and corneal fluorescein staining was increased in 18% at 1 week. There were no differences in the OSDI, Schirmer with anesthesia, TBUT, corneal fluorescein, or conjunctival lissamine green staining when preoperative values and hinge location were compared.

CONCLUSIONS

Mild dry-eye disease was present early after myopic LASIK with the IntraLase laser. Hinge position had no effect on central corneal sensation or dry-eye disease.