Abstract
Purpose:
To evaluate the efficacy of long-term treatment with 3% diquafosol solution (DQS), that is a P2Y2 receptor agonist facilitating mucin secretion from the conjunctival goblet cells, for chronic dry eye after laser in situ keratomileusis (LASIK).
Methods:
This prospective clinical study comprising 18 eyes (9 patients) to which DQS was additionally instilled 4 times a day. Tear secretin, tear break-up time (BUT), superficial punctate keratitis (SPK), and conjunctivitis sicca were examined before and at 1,3, 6, 9 and 12 months after treatment. Tear secretin was examined with the Schirmer test with anesthesia before and after the DQS treatment. And also, Tear breakup time (BUT), fluorescein stain, and lissamine green stain were examined before and after the DQS treatment. A questionnaire survey regarding 14 symptoms was also assessed before treatment and at 12 months after. The changes in BUT and staining scores between before and after DQS treatment were examined using Kruskal-Wallis test following the Steel-Dwass multiple comparison. Changes in the tear secretion and each symptom in the questionnaire were compared using the Wilcoxon signed-ranks test. P<0.05 was considered significant.
Results:
DQS treatment, tear secretin did not change, thought BUT significantly increased after 1,3,6,9 and 12 months . SPK improved at all evaluation points. Lissamine green score improved after 6,9 and 12 months. Of the 14 items on the symptoms questionnaire, dryness, discomfort, grittiness were improved.
Conclusions:
DQS was long-term effective in improving ocular surface disorder and dry eye symptoms after LASIK. The mechanism of the improvement was assumed to be improved levels of mucin and tears in the tear film. DQS is another therapy for addressing LASIK-associated dry eye syndrome.
Keywords: 486 cornea: tears/tear film/dry eye •
485 cornea: surface mucins •
479 cornea: clinical science