Clinical Efficacy of Topical Diquafosol Tetrasodium after Laser Epithelial Keratomileusis

Min Kyo Kim; Hyun Kyo Jeong; Ahn Ji Min; Kim Hong Seok

doi:10.3341/jkos.2015.56.9.1324

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Kim, Jeong, Ji Min, and Hong Seok: Clinical Efficacy of Topical Diquafosol Tetrasodium after Laser Epithelial Keratomileusis

Original Article

J Korean Ophthalmol Soc 2015;56(9):1324-1330.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.9.1324

Clinical Efficacy of Topical Diquafosol Tetrasodium after Laser Epithelial Keratomileusis

Min Kyo Kim, MD^1,², Hyun Kyo Jeong, MD^1,², Ahn Ji Min, M.D¹, Kim Hong Seok, M.D^1,

¹Siloam Eye Hospital, Seoul, Korea

²The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Hong Seok Kim, MD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0880, Fax: 82-2-2650-0895 E-mail: curiokim@naver.com

Received 13 March 201529 April 2015 Accepted 6 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical effectiveness of topical diquafosol tetrasodium (DQS) after laser epithelial keratomileusis (LASEK).

Methods

This randomized prospective study included 97 eyes of 49 patients who were scheduled for LASEK. Patients in the DQS group used both 0.3% sodium hyaluronate and 3% DQS for 3 months after surgery while patients in the control group used only 0.3% sodium hyaluronate. Corneal staining score, tear film break-up time (TF-BUT), Schirmer test and ocular surface dis-ease index (OSDI) were evaluated before surgery and 2, 4, 8, 12 and 16 weeks after surgery.

Results

There was no significant difference in visual acuity, spherical equivalent and corneal haziness between the 2 groups af-ter surgery. Corneal staining score was significantly lower in the DQS group than in the control group 2 weeks after LASEK ( p < 0.01) and increased in the control group after LASEK compared with the preoperative value (2 weeks after LASEK, p < 0.01), but decreased in the DQS group (12 and 16 weeks after LASEK, p < 0.05). TF-BUT was significantly higher in the DQS group than in the control group 2 to 16 weeks after LASEK ( p < 0.01) and increased values were observed in the DQS group after LASEK compared with the preoperative value (4 to 16 weeks after LASEK, p < 0.05). The mean OSDI was significantly higher 4 to 16 weeks after LASEK in the control group than in the DQS group ( p < 0.01).

Conclusions

Subjective dry eye symptoms and objective markers were worse for 4 weeks after LASEK. The use of 3% DQS for 12 weeks after surgery improved these symptoms and markers with the effect lasting 16 weeks after LASEK.

Keywords: Diquafosol tetrasodium, Dry eye syndrome, LASEK, Refractive surgery

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Figure 1.

Changes in visual acuity (A), Schirmer test (B), corneal staining score (C), tear film break-up time (D), ocular surface dis-ease index (E), and corneal haziness grade (F) in the 3% diquafosol tetrasodium and the control groups before and after LASEK. LASEK = laser-assisted sub-epithelial keratectomy; Preop = preoperation. ^* p < 0.05 compared with preoperative value; ^† p < 0.05 between Diquafosol and control group.

Table 1.

Characteristics of patients who underwent LASEK and were treated with or without topical 3% diquafosol tetrasodium

	Diquafosol group	Control group	p-value
Sex (male:female)	13:14	10:12	0.10^∗
Age (years)	24.55 ± 7.98	25.68 ± 5.90	0.44^†
UCVA (log MAR)	1.07 ± 0.32	0.98 ± 0.29	0.99^†
Spherical equivalent (diopters)	-5.26 ± 1.92	-5.56 ± 2.09	0.93^†
Central corneal thickness (μ m)	536.04 ± 26.51	545.54 ± 31.79	0.46^†
Schirmer test (mm)	12.9 ± 8.0	12.9 ± 9.1	0.46^†
Corneal staining score	0.2 ± 0.4	0.2 ± 0.4	0.26^†
Tear film break-up time (sec)	5.8 ± 1.3	6.0 ± 1.1	0.11^†
Ocular surface disease index	10.1 ± 7.2	9.5 ± 5.0	0.47^†
Ablation depth (μ m)	97.17 ± 25.92	103.36 ± 27.24	0.66^†

Values are presented as mean ± SD unless otherwise indicated. LASEK = laser-assisted sub-epithelial keratectomy; UCVA = uncorrected visual acuity.

^∗ Chi-square test;

^† Independent t-test.

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