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J. C. Huang, C.-C. Sun, C.-K. Chang, D. H. Ma, Y.-F. Lin; Effect of Different Hinge Position on Corneal Sensation and Dry Eye Parameters After Laser in situ Keratomileusis Using a Femtosecond Laser. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2851.
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To evaluate the effect of hinge positions on corneal sensation and dry eye parameters after femtosecond laser assisted-LASIK procedures.
Fourty-four consecutive patients (88 eyes) with mean age of 29.84±4.75 years who underwent bilateral myopic LASIK surgery with IntraLase (AMO, USA) were evaluated in a prospective nonrandomized contralateral-eye study to compare the difference between nasal-hinge and superior-hinge locations. Central Cochet-Bonnet esthesiometry, Schirmer basic tear secretion test, tear breakup time (TBUT), ocular surface staining with fluorescein and Rose bengal strips, and a subjective questionnaire (Ocular Surface Disease Index, OSDI) were evaluated preoperatively and at 1 week and 1, 3, and 6 months postoperatively.
After surgery, the corneal sensation decreased significantly in both nasal-hinge and superior-hinge flaps at 1 week but returned to baseline by 1 month. The Schirmer basic secretion test values were not significantly changed postoperatively in the nasal-hinged and superior hinged eyes. TBUT decreased insignificantly at 1 week and 1 month postoperatively and recovered by 3 months after surgery in both groups. Corneal fluorescein staining increased significantly in both nasal- and superior-hinged flaps at 1 week and gradually recovered by 3 months postoperatively in both groups. There was no significant change from preoperative values in Rose bengal staining at all time points postoperatively in nasal- and superior-hinge eyes. The OSDI was significantly increased 1 week after surgery and gradually but not completely returned to baseline at 6 months postoperatively in both nasal- and superior- hinge flaps. There were no significant differences in all the subjective and objective parameters tested between nasal-hinged and superior-hinged flaps at any time point.
Femtosecond laser-assisted LASIK procedures reduce corneal sensitvity and increased corneal staining postoperatively, but recovered to baseline value within 3 months. The subjective ocular surface disease index values increased after surgery and did not improve by 6 months postoperatively. Difference of hinge position in Femtosecond laser-assisted LASIK had no significant effect on central corneal sensation and dry-eye parameters.
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