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J. Pepose, B. Huang, A. Mirza, M. Qazi; Effect of Punctal Occlusion on Wavefront Aberrations in Dry Eyes after LASIK . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2628.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the total and higher order aberrations in dry eyes after LASIK before and after punctal occlusion. Methods: Fourteen eyes of seven patients who were diagnosed with dry eyes after LASIK surgery were examined. The wavefront aberrations of the eyes were measured with a Hartmann-Shack type wavefront sensor (Zywave, B&L) before and after punctal plug insertion. Higher-order aberrations were calculated with Zernicke polynomials up to fifth order. Student t-tests were used to assess the statistical significance between the pre and post punctal plug measurements. Results: The Mean ± Standard error of root mean square (RMS) of total, lower and higher order wavefront aberrations were 4.16 ± 0.88, 2.80 ± 0.80 and 1.36 ± 0.35 in fourteen eyes of seven patients with dry eye after LASIK. Punctal occlusion in these dry eye patients significantly reduced these wavefront aberrations by 47-64% (p<0.01). Amongst higher order aberrations, there were significant reductions in coma and spherical aberration, but not in trefoil after the punctal occlusion. The reduction of wavefront aberrations by punctal occlusion in dry eyes resulted in a significant improvement in quality of vision, confirmed with image simulation software. Conclusions: Zywave wavefront aberrometry provides a useful, objective assessment of patients with complaints of dry eyes after LASIK. Punctal occlusion significantly reduces wavefront aberrations, improves dry eye symptoms and the quality of vision.
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