Effect of hinge position on corneal sensation and dry eye after laser in situ keratomileusis using a femtosecond laser
Accepted 17 March 2007.
Purpose
To determine whether hinge position has an effect on corneal sensation and dry-eye symptoms after myopic laser in situ keratomileusis (LASIK) performed with the IntraLase femtosecond laser (IntraLase Corp.).
Setting
University-based academic practice, Ann Arbor, Michigan, USA.
Methods
Sixty-six consecutive eyes of 33 patients were prospectively evaluated in a randomized contralateral-eye study to compare the difference between superior-hinge and temporal-hinge locations after bilateral myopic LASIK with the IntraLase femtosecond laser. Central Cochet-Bonnet esthesiometry, the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer test with anesthesia, tear breakup time (TBUT), corneal fluorescein, and conjunctival lissamine green staining were evaluated preoperatively as well as 1 week and 1, 3, 6, and 12 months after surgery.
Results
Corneal sensation was reduced with both superior-hinged and temporal-hinged LASIK flaps 1 week and 1, 3, 6, and 12 months after surgery (P<.0001). There was no difference in corneal sensation between superior-hinged and temporal-hinged flaps at any time point. The OSDI score was increased in 22.6% of patients at 1 week and 21.9% at 1 month (P<.00001), and corneal fluorescein staining was increased in 18% at 1 week. There were no differences in the OSDI, Schirmer with anesthesia, TBUT, corneal fluorescein, or conjunctival lissamine green staining when preoperative values and hinge location were compared.
Conclusions
Mild dry-eye disease was present early after myopic LASIK with the IntraLase laser. Hinge position had no effect on central corneal sensation or dry-eye disease.
From the Department of Ophthalmology and Visual Sciences (Mian, Shtein, Nelson, Musch), W.K. Kellogg Eye Center, University of Michigan Medical School, and the Department of Epidemiology (Musch), School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
Corresponding author: Shahzad Mian, MD, W.K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, Michigan 48105, USA.
No author has a financial or proprietary interest in any material or method mentioned.
Presented in part at the annual meeting of the American Academy of Ophthalmology, Chicago, Illinois, USA, October 2005, and ASCRS Symposium on Cataract, IOL and Refractive Surgery, Washington, DC, USA, April 2005.
ABSTRACT