Abstract
Purpose: :
To evaluate the role of punctual occlusion preoperatively in contact lens (CTL) wearers to prevent postoperative dry eye complaints in patients presenting for laser vision correction surgery.
Methods: :
A retrospective chart review was conducted on 72 eyes of 36 patients who presented for Laser-Assisted Sub-Epithelial Keratectomy (LASEK) over a 3 year period. All 36 patients were CTL wearers. Patients were separated into two cohorts: CTL wearers that tested positive for dry eye syndrome (DES) with Shirmer I testing and received preoperative punctal occlusion versus those that did not receive punctal occlusion. A control group included CTL wearers who tested negative for DES via Shirmer I testing and did not receive preoperative punctal occlusion. Patients then underwent LASEK surgery and a dry eye questionnaire was completed postoperatively to assess for complaints of continued DES.
Results: :
A review of the data showed that of the 8 patients in the CTL group who tested positive for DES and received punctal occlusion, 2 (25%) had post-operative DES complaints at an average of 4.6 months. Of the 5 patients in the CTL group who tested positive for DES and did not receive punctal occlusion, 2 (40%) had post-operative DES complaints at an average of 5.6 months. Of the 23 patients in the CTL group who tested negative for DES and did not receive punctal occlusion, 8 (35%) had post-operative DES complaints at an average of 5.2 months.
Conclusions: :
DES is commonly found in patients who present for laser vision correction surgery. This study looked at CTL wearers who presented for laser vision correction surgery. Those CTL wearers who objectively tested positive for DES and received preoperative punctal occlusion had a lower incidence of post-operative dry eye complaints (25%) than CTL wearers who tested positive for DES but did not receive preoperative punctal occlusion (40%). A control group of CTL wearers who tested negative for DES and did not receive preoperative punctal occlusion had a rate of postoperative DES complaints of 35%. These findings indicate that in CTL wearers who undergo laser vision corrective surgery and test positive for DES preoperatively, the rate of postoperative complaints is less if they have preoperative punctal occlusion. This information should be included in all preoperative counseling to help ensure postoperative patient satisfaction.
Keywords: cornea: tears/tear film/dry eye • refractive surgery • lacrimal gland