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Kevin A. Budman, Bethany B. Markowitz, Adam G. Chun; Comparison Of Incidence Of Development Of Dry Eye Complaints In A Population With Dry Eye Syndrome Following Laser Refractive Surgery In Contact Lens Versus Non-contact Lens Wearers. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3756.
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To evaluate preoperative and postoperative complaints of ocular surface dryness and discomfort in a population of contact lens wearers versus non-contact lens wearers after laser vision correction surgery.
A retrospective chart review of 104 eyes of 52 consecutive patients who presented for Laser-Assisted Sub-Epithelial Keratectomy between 2006-2008 was performed. Patients were separated into two cohorts: contact lens wearers versus a control non-contact lens wearers. Ocular surface dryness was assessed via a dry eye questionnaire and Schirmer 1 testing for each group preoperatively. These cohorts were further subdivided into abnormal versus normal Schirmer I testing. Those with abnormal Schirmer I testing and no complaints of ocular surface dryness preoperatively were isolated to see how many developed subjective sensations of dry eye syndrome (DES) postoperatively in each cohort.
Data review showed that of the 35 patients in the contact lens group, 12 patients (34%) tested positive for DES by a Schirmer I test of 10mm or less in at least one eye preoperatively. Of these, 10 patients (83%) had no dry eye complaints preoperatively. A postoperative questionnaire completed at an average of 5.1 months showed that of the 10 patients with a dry Schirmer I and no complaints of dry eye preoperatively, 4 patients (40%) had dry eye complaints postoperatively. Of the 17 patients in the non-contact lens group, 12 patients (70%) tested positive for DES by a Schirmer I preoperatively. None in this group (0%) had dry eye complaints preoperatively. A postoperative questionnaire completed at an average of 5.7 months showed of the 12 patients with a dry Schirmer I preoperatively, 6 had dry eye complaints (50%).
DES is commonly found in patients who present for laser vision correction surgery. The subjective preoperative assessment indicates that contact lens wearers are more likely to report dry eye symptoms. However, Schirmer I testing indicates that the non-contact lens wearers were more likely to have an objective measurement of DES. Postoperatively, non-contact lens wearers were more likely to complain of dry eye symptoms than contact lens wearers. Given these findings, it is important to obtain objective testing for DES preoperatively in laser vision correction surgery patients as preoperative subjective complaints do not correlate well with objective testing. Also, non-contact lens wearers are more likely to become more symptomatic of their proven preoperative DES in the postoperative period.
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