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Prevalence of Dry Eye Disease in Laser-Assisted In Situ Keratomileusis Candidates
Cristian Cartes1, Camila Aravena, Alejandro Monsalve
1Unidad Oftalmología (C.C., C.A., A.M., R.M., L.N.), Departamento de Especialidades, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile; Oftamédica Clinic (C.C., C.R., D.Q., F.C., R.M., L.N., Daniela Araya, Daniela Araneda), Temuco, Chile; Programa de Doctorado en Salud Ecosistémica (C.S.), Centro de Investigación de Estudios Avanzados del Maule, Universidad Católica del Maule, Talca; Laboratorio de Microbiología y Parasitología (C.S.), Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad Católica del Maule, Talca, Chile; and Departamento de Tecnología Médica (M.S.), Facultad de Ciencias de la Salud. Universidad Católica del Maule, Talca, Chile.
Objective:
To evaluate the prevalence of dry eye disease (DED) in laser-assisted in situ keratomileusis (LASIK) candidates.
Methods:
A chart review of consecutive LASIK candidates who underwent full ocular surface work-up was performed, including ocular surface disease index (OSDI), noninvasive tests (noninvasive tear breakup time [ni-TBUT], tear meniscus height, lipid layer thickness, and meibography), and invasive tests (Schirmer test I, fluorescein TBUT, corneal staining, and meibomian gland [MG] expressibility). The prevalence of DED was calculated according to the Dry Eye Workshop II (DEWS II), and Japanese and Asia Dry Eye Society (JDES/ADES) criteria.
Results:
In total, 135 patients (270 eyes) were evaluated. The mean age was 32.6±8.3 years, and 62.9% were women (n=85); 19 patients (15.4%) wore contact lenses, and 31 patients (23.8%) used artificial tears. The mean OSDI was 18.2±16.9, which was abnormal in 54.1% (n=62). Inferior lid MG dropout was the sign with the highest percentage of abnormal results (61.5%; n=83). There were no differences between men and women in any test except for ni-TBUT (6.3±0.3 and 7.2±0.2, respectively; P=0.002). Dry eye disease prevalence was 25.9% and 53.3%, according to JDES/ADES and DEWS II criteria, respectively. The only significant risk factor for DED was artificial tear use for both DEWS II (odds ratio [OR]=3.5, confidence interval [CI] [1.35-9.39]) and JDES/ADES (OR=2.58, CI [1.03-6.48]).
Conclusions:
This study found a high prevalence of DED and abnormalities in LASIK candidates and highlights the importance of ocular surface evaluation before photorefractive surgery.
