Abstract
Abstract: :
Purpose: : Dry eye is one of major complications after LASIK. Although the mechanism contributing post–LASIK dry eye is unclear, it is suggested that loss of neurotrophic effect by flap creation may cause aqueous tear deficiency and decreased tear stability on the cornea. Artificial tears, commonly used for post–LASIK dry eye management, are sometimes not enough to improve symptoms. Warm compression for eyelid is effective for evaporative dry eye associated with meibomian gland dysfunction (MGD) by increasing tear stability on the cornea. We investigated whether warm compression may also effective for non–MGD, post–LASIK dry eye. Methods: (1) To determine the immediate effect of single use of disposable eyelid warming device (Eye Steamer, Kao, Tokyo), 10 non–MGD dry eye patients used Eye Steamer for 10 minutes. BUT, Schirmer test, and thickness of lipid layer were measured before and immediately after eyelid warming. (2) Forty six consecutive patients who underwent bilateral LASIK were divided into two groups in random fashion; 22 patients who were instructed to use Eye Steamer for 10 minutes every day from the day 14th to 28th postoperatively (ES), and 24 patients who did not use Eye Steamer (NES). Dry eye symptoms, tear break–up time (BUT), fluorescein staining of cornea, Schirmer test, corneal sensitivity, and thickness of precorneal lipid layer were examined before, 1 week and 1 month after LASIK Results: (1) BUT was significantly improved after single eyelid warming (before: 3.6±1.3 sec, after: 4.5±1.9 sec). Thickness of lipid layer was significantly increased. (2) BUT was 5.3±2.3 sec, in ES and 5.5±2.9 sec. in NES at 1 week, and significantly better in ES (5.6±2.5 sec.) as compared to NES (4.4±2.5 sec.) after using Eye Steamer at 1 month postoperatively (p<0.05). Positive fluorescein staining was observed 6 eyes in ES and in 17 eyes in NES at 1 month (p<0.05). Conclusions: Our results suggest that eyelid warming with Eye Steamer is effective for non–MGD, post–LASIK dry eye by improvement of tear stability.
Keywords: cornea: tears/tear film/dry eye • refractive surgery: LASIK • lipids