Comparing the prevalence of ocular surface disorder in patients who underwent refractive surgery (laser vision correction or implantable collamer lens) 5–15 years ago to a similar population with no history of surgery

Session Details

Session Title: Corneal Refractive Surgery

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:18

Venue: Free Paper Forum: Podium 3

First Author: : B.Gjerdrum NORWAY

Co Author(s): :    K. Gundersen   B. Aakre                          

Abstract Details

Purpose:

The purpose of the study was to determine the prevalence of Ocular Surface Disorder (OSD) in patients with a history of laser vision correction (LVC) or implantable collamer lens (ICL) implantation 5-15 years ago relative to a matched control group with no history of refractive surgery. Differences in prevalence based on testing methodology were also evaluated.

Setting:

The study involved data from one private eye clinic in Haugesund, Norway

Methods:

This was a cross-sectional case-control study with a randomly chosen test eye. The subject population included patients who had LVC or ICL 5 to 15 years ago. The control group was age and sex matched with the LVC group. Subjects were required to have good ocular health, with no pathology or systemic disease involving the corneal surface, except for OSD. OSD was evaluated using the subjective Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity (measured in both eyes), non-invasive keratography tear break-up time (NIKBUT), meibography, the dynamic Objective Scatter Index (OSI) and the Schirmer 1 test.

Results:

The study included 258 subjects (95 LVC, 80 ICL, 83 control). The prevalence of OSD determined by osmolarity was significantly higher in the LVC group vs. the control (74% vs. 50%, Person´s chi-squared, p = 0.001), but not significantly different between the ICL and control group. No other objective tests showed any significant difference between LVC or ICL and the control group. The prevalence of OSD based on the OSDI was lower in the LVC group relative to the control (19% vs 31%); this was not statistically significant (p= 0.06). The ICL prevalence was the same as the control (31%).

Conclusions:

Osmolarity differences between patients having had LVC 5 to 15 years ago suggested a significantly higher prevalence of OSD than a matched control group, a difference not seen in the ICL group. In contrast, the subjective OSDI showed a trend for a lower prevalence of OSD in the LVC group. This may be a function of insufficient nerve regeneration after LVC. Objective measures of OSD might be better than subjective measures when evaluation dry eye in LVC patients.

Financial Disclosure:

None