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Dry Eye

New Data Challenges Current Beliefs Surrounding Dry Eye, LASIK

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Conventional wisdom concerning dry eye and LASIK does not always hold true, claims Julie Schallhorn, MD, MS, assistant professor of Ophthalmology, University of California San Francisco, who presented findings from a large population-based study of patients undergoing refractive surgery at the 2019 ASCRS-ASOA annual meeting.

According to Schallhorn, commonly held misconceptions include that LASIK makes dry eye worse, women are more likely to get bad dry eye after LASIK, and patients with dry eye prior to surgery should have photorefractive keratectomy (PRK) because LASIK will make their dry eye worse.

Data presented showed that dry eye present prior to surgery tends to get better afterward, being female has a very minimal effect on worsening dry eye after surgery, and that patients who had PRK reported more dry eye symptoms than those who had LASIK at 3-month follow-up.

The study included >12,000 patients (>24,000 eyes) who had refractive surgery over a 2-year period. Data were collected from confidential questionnaires that were completed before surgery and 3 months postoperative.

Overall, 41.5% of patients reported having dry eye symptoms before surgery, with women being 23% more likely than men to have reported dry eye symptoms and contact lens wearers being 45% more likely to report dry eye symptoms than their counterparts who were not wearing contact lenses.

Although some patients reported developing dry eye symptoms after surgery, patients who reported dry eye preoperatively tended to improve. Females reported worse dry eye symptoms after surgery than men, but the change in severity was only minimally affected by gender.

There was no significant difference in preoperative dry eye symptoms between patients who had PRK versus those who had LASIK. PRK was an independent predictor associated with change in dry eye symptoms before and after surgery.


Schallhorn J. Challenging conventional wisdom about LASIK. Presented at: ASCRS-ASOA annual meeting; May 3-7, 2019; San Diego, CA.

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