Comparison of two treatments for dry eye disease after corneal refractive surgery

There are no international or Chinese guidelines for the management of dry eye disease that develops after corneal refractive surgery. Sodium hyaluronate is the first-line therapy for dry eye diseases but is not sufficient to treat severe conditions. This study aimed to compare three-month outcomes following treatment of dry eyes after corneal refractive surgery with 3% diquafosol against those with 0.1% sodium hyaluronate. In a retrospective study, 118 patients were treated with 3% diquafosol sodium six times/day (DQS cohort, n=118 eyes) and 184 patients were treated with 0.1% sodium hyaluronate four times/day (SH cohort, n=184 eyes) for three months. Before treatments (BT), the ocular surface damage score was between 5 and 9 per eye, the ocular surface disease index was between 64 and 70% per eye, and the subjective symptom questionnaire score was between 13 and 19 per eye. Wet length of Schirmer's I strip test, ocular surface damage score, ocular surface disease index, and subjective symptom questionnaire scores improved in both cohorts after 3 months of treatments (AT) compared to BT conditions (P<0.01 for all comparisons). However, improvement was greater in the DQS cohort than in the SH cohort in the AT condition (P<0.01 for all comparisons). Blurred vision, ocular discomfort, and foreign body sensations were observed in a few cases. Dry eye disease is a common complication after corneal refractive surgery, and there is a lack of international guidelines addressing its management. Three percent diquafosol showed superior improvement of dry eye parameters post-refractive surgery than 0.1% sodium hyaluronate.