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Carlos Medina, Luis Carlos Escaf; COMPARISON OF OCULAR SURFACE CHARACTERISTICS BETWEEN PATIENTS AFTER LASER IN SITU KERATOMILEUISIS (LASIK) AND SJOGREN SINDROME. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3928.
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© ARVO (1962-2015); The Authors (2016-present)
It has been documented that LASIK induces dry eye by corneal denervation and impairment of lacrimal reflex. We performed a retrospective, observational study in which be compared the ocular surface and tear film characteristics in LASIK and Sjogren patients. Our aim was to establish, if dry eye syndrome induced by LASIK produces tear film alterations similar to an inflammatory disease like Sjogren Syndrome
We performed an evaluation of the characteristics of the tear-film of fifty eyes of 25 patients with Sjogren Syndrome, diagnosis based on Sjögren’s International Collaborative Clinical Alliance (SICCA) criteria, fifty consecutive eyes of 25 patients who underwent LASIK in out institution and a group of fifty eyes in 25 asymptomatic patients (Control Group), with unremarkable biomicroscopic examination. Osmolarity measurement (performed with TearLab® Osmolarity System), Schirmer test I, Tear Break Up Time (TBUT), Ocular Surface Staining graded according to Oxford Scheme modified, and Ferning test were performed.
Tear osmolarity was 316.7±2.1 in the LASIK group , 321,6±2.6 in the Sjogren group and 305.9±1.2 in the control group there was a significant difference between Lasik and Sjogren vs Normal group (P = <0,001 ) but not between Lasik vs Sjogren (P= 0,183)Lacrimal Volume: The average Schirmer value for every group was 19,9±1.1 mm, 13,0±1.2 mm and 21,4±0.9 for groups LASIK, Sjogren and Control respectively. There was a statistical difference between Lasik and Normal vs Sjogren (ANOVA P = <0,001) but not between Lasik and normal.Tear Break Up Time: TBUT was 7,0±0,4 seconds (secs) in the Lasik group, 7,4±0,3 secs in the Sjogren group and 10.5±0,6 secs in the control group, there was a significant difference between Lasik and Sjogren vs Normal group (ANOVA P = <0,001) but not between Lasik and Sjogren.Ocular Surface Disease Index: The average OSDI value for every group was 37.9±3.6 % in the Lasik group, 41.3±4.3% in Sjogren group and 27.4±3.4% in control group, there was a statistical difference between LASIK and Sjogren vs normal (ANOVA P = <0,001) but not between Lasik and Sjogren.
Even though, Sjogren and LASIK induced dry eye have different pathophysiological mechanisms in this study we evidenced that both can produced ocular surface alterations that share similar characteristics in the clinical setting.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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