Laser-assisted in situ keratomileusis for patients with dry eye

Objective: To evaluate the efficacy and safety of laser-assisted in situ keratomileusis (LASIK) in patients with preoperative dry eye. Methods: We divided the 543 eyes that underwent LASIK into the following 3 groups: eyes with definite dry eye (DE group), with probable dry eye (PDE group), and without dry eye (NDE group). We evaluated visual outcome, dry-eye status, and complications. Outcome Measures: We compared uncorrected and best-corrected visual acuity, manifest refraction, symptoms, tear function, ocular surface abnormality, complications, corneal sensitivity, endothelial cell count, and patient satisfaction among the groups. Results: We found no significant differences among the groups in uncorrected and best-corrected visual acuity, manifest refraction, and patient satisfaction. A dry-eye symptom, dryness, was more severe in the DE than the NDE group after LASIK. The mean results of the Schirmer test with anesthesia and tear breakup times were significantly lower and the fluorescein score was higher in the DE than the NDE groups after LASIK. We found no differences in the incidence of complications among the groups. Corneal sensitivity was recovered within 6 months after LASIK in the DE and PDE groups and within 3 months in the NDE group. Conclusions: The efficacy and safety of LASIK were not affected by preexisting dry eye. However, preexisting dry eye is a risk factor for severe postoperative dry eye with lower tear function, more vital staining of the ocular surface, and more severe symptoms.