Yahalomi Tal, Achiron Asaf, Arnon Roee, Stanescu Nir, Pikkel Joseph
Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashdod 7747629, Israel.
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.
J Clin Med. 2023 May 30;12(11):3761. doi: 10.3390/jcm12113761.
Dry eye disease is the most frequent non-refractive postoperative complication following refractive surgery. This prospective study investigated the development of dry eye disease after three common refractive laser surgeries: laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and laser-assisted sub-epithelial keratectomy (LASEK). Patients who underwent uneventful refractive surgery in a single private medical center between May 2017 and September 2020 were included. Ocular surface disease was graded according to the Dry Eye Workshop severity (DEWS) classification. Patients were examined 6 months following refractive surgery. The analysis included 251 eyes of 137 patients: 64 eyes (36 patients) after LASEK, 90 eyes (48 patients) after PRK, and 97 eyes (53 patients) after LASIK. At 6 months post-surgery, the DEWS score was higher for the LASIK than the PRK and LASEK groups ( = 0.01). For the total cohort, severe DEWS score (grades 3 and 4) at 6 months post-surgery was correlated with female gender ( = 0.01) and to the amount of refractive correction ( < 0.001), but not to age ( = 0.87). In conclusion, LASIK surgery and female gender were associated with dry eye. Patients, particularly those with high myopia, should be counseled about the risk of developing dry eye after refractive surgeries.
干眼是屈光手术后最常见的非屈光性术后并发症。这项前瞻性研究调查了三种常见屈光性激光手术后干眼的发生情况：准分子原位角膜磨镶术（LASIK）、准分子激光角膜切削术（PRK）和准分子激光上皮下角膜磨镶术（LASEK）。纳入了2017年5月至2020年9月期间在一家私立医疗中心顺利接受屈光手术的患者。根据干眼研讨会严重程度（DEWS）分类对眼表疾病进行分级。屈光手术后6个月对患者进行检查。分析包括137例患者的251只眼：LASEK术后64只眼（36例患者），PRK术后90只眼（48例患者），LASIK术后97只眼（53例患者）。术后6个月，LASIK组的DEWS评分高于PRK组和LASEK组（P = 0.01）。对于整个队列，术后6个月严重DEWS评分（3级和4级）与女性性别（P = 0.01）和屈光矫正量（P < 0.001）相关，但与年龄无关（P = 0.87）。总之，LASIK手术和女性性别与干眼有关。应向患者，尤其是高度近视患者，告知屈光手术后发生干眼的风险。
