December 2015




EyeWorld journal club

Evaluation of dry eye after femtosecond laser-assisted cataract surgery: a prospective study

Yinhui Yu, MD, Huixia Hua, MS, Menghan Wu, MS, Yibo Yu, MD, Wangshu Yu, MS, Kairan Lai, PhD, Ke Yao, MD


J Cataract Refract Surg (Dec) 2015;41. Article in press

Purpose: To evaluate dry eye signs and symptoms in patients who underwent femtosecond laser-assisted cataract surgery (FLACS) and those with phacoemulsification cataract surgery (PCS).

Setting: Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China

Design: Prospective consecutive nonrandomized comparative cohort study

Methods: Consecutive patients who had FLACS or PCS were assessed. Dry eye markers including Ocular Surface Disease Index (OSDI) and subjective symptom questionnaire, tear film assessment using Keratograph 4, Schirmer testing I (STI), and fluorescein staining (FI) were sequentially evaluated preoperatively and postoperatively at 1 day, 1 week, and 1 month.

Results: 137 eyes from 137 patients were recruited. Baseline characteristics were well balanced. Evaluations indicated that most patients developed dry eye postoperatively. Subjective symptoms and FI scores elevated from baseline, tear break-up time and STI values decreased postoperatively, which peaked at 1 week and did not return to baseline within 1 month. There were no significant differences between the 2 groups (all P>0.05) except that the laser group was associated with a higher FI score at 1 day (P=0.001), 1 week (P=0.047), and 1 month (P=0.025). OSDI score and subjective symptoms were greater in the laser group at 1 week (P=0.014 and P=0.016, respectively). When conducting subgroup analysis, obvious aggravation was also observed by FI at 1 day (P=0.016) and 1 month (P=0.009) in pre-surgical dry eye patients.

Conclusions: Both FLACS and PCS would aggravate dry eye postoperatively. FLACS resulted in higher risk of staining and dry eye symptoms. Furthermore, pre-existing dry eye patients who underwent FLACS had more severe ocular surface staining than those with PCS.

Related articles:

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The femtosecond choice by Enette Ngoei EyeWorld Contributing Editor

The future of laser-assisted cataract surgery: Clinical results and patient flow

Why not femto? by Faith A. Hayden EyeWorld Staff Writer

Evaluation of dry eye after femto laser-assisted cataract surgery Evaluation of dry eye after femto laser-assisted cataract surgery
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