First Author: Z.Hassan HUNGARY
Co Author(s): E. Szalai G. Nemeth A. Berta L. Modis
Purpose:
To assess tear osmolarity using the new TearLab device after LASIK, and to compare values with those obtained by traditional tear-film tests prior to and after procedure.
Setting:
Orbi-Dent Health and Laser Center 1 and the Department of Ophthalmology, Medical Health and Science Center, University of Debrecen, 2 Hungary.
Methods:
In present study, 30 eyes of 15 patients with refractive error (10 women and 5 men) were examined with TearLab osmometer and traditional tear-film tests prior to LASIK treatment. Mean age was 30.55±11.79 years (range 18 to 56). A comparative study was carried out preoperatively and postoperatively. Patients had no history of ophthalmologic events (damage, operation, or ophthalmologic symptoms due to other systemic diseases) other than refractive error. Prior to LASIK and after a thorough aptitude test, best corrected and uncorrected visual acuities were determined. Subsequently, tear osmolarity measurement was conducted using the TearLab device and traditional tests: Schirmer test, tear-film break up time (BUT) and staining. At slit-lamp examination the presence of the lid parallel conjunctival folds (LIPCOF), and the state of Meibom-gland-dysfunction (MGD) were investigated.
Results:
Preoperative corrected visual acuity of patients increased from 0.939+0.15 to 0.96+0.18 60 days after surgery (p=0.007), uncorrected visual acuity improved from 0.20+0.160 to 0.831+0.230 60 days after procedure (p=0.02). Significance was observed only in uncorrected visus already on the first day after treatment (p=0.001).
Tear osmolarity was a mean value of 303.62+12.29 mOsm/l before surgery, and 303.58+20.14 mOsm/l 60 days after treatment (p=0.689). Mean LIPCOF was 0.68+0.68 prior to procedure, and 0.583+0.65 subsequent to surgery (p=0.248). Meibom-gland-dysfunction (MGD) was not detected. Schirmer-test values were a mean of 25.55+8.06 mms before treatment, and 22.71+11.09 60 days after (p=0.364). Tear-film break up time (BUT) was a mean of 12.52+6.35 mms, and 12.25+9.02 mms 60 days after treatment (p=0.511). Cornea showed no staining with fluorescein.
No significant deviation was observed in the values of Schirmer-test, corneal staining, BUT and LIPCOF when compared to postoperatively obtained values during follow-up period.
Conclusions:
Tear hyperosmolarity plays a crucial role in refractive surgery. For a screening purpose, an examination using TearLab device may be applicable however, in uncertain cases it is considerable to use its combination with conventional diagnostic tests for dry eye. According to our results, no significant correlation was found between values obtained by tear osmolarity and other tests in our proband group. LASIK treatment is safe for dry eye involving the administration of adequate artificial tears for a minimum of 3-6 months. FINANCIAL DISCLOSURE?: No
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