Dry Eye Syndrome after Refractive Surgery: Comparative Outcomes of SMILE and LASIK

Ho Gil Jung; Gi Hyun Bae; Joo Young Kwag; Joo Hyun; Jin Seok Choi; Kyu Hong Pak; Sung Kun Chung

doi:10.3341/jkos.2019.60.5.407

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Jung, Bae, Kwag, Hyun, Choi, Pak, and Chung: Dry Eye Syndrome after Refractive Surgery: Comparative Outcomes of SMILE and LASIK

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(5): 407-413.

Published online: 15 May 2019

DOI: https://doi.org/10.3341/jkos.2019.60.5.407

Dry Eye Syndrome after Refractive Surgery: Comparative Outcomes of SMILE and LASIK

Ho Gil Jung, MD¹, Gi Hyun Bae, MD¹, Joo Young Kwag, MD², Joo Hyun, MD², Jin Seok Choi, MD, PhD², Kyu Hong Pak, MD², Sung Kun Chung, MD, PhD²

¹Department of Ophthalmology, SahmYook Medical Center, Seoul, Korea.

²Saevit Eye Hospital, Goyang, Korea.

Address reprint requests to Sung Kun Chung, MD, PhD. Saevit Eye Hospital, #1065 Jungang-ro, Ilsandong-gu, Goyang 10447, Korea. Tel: 82-31-900-7700, Fax: 82-31-900-7777, eyekun@gmail.com

Received 26 July 2018 Revised 28 September 2018 Accepted 23 April 2019

The Korean Ophthalmological Society

(open-access):

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 determine possible differences in dry eye syndrome in relation to surgery methods, especially between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), in Korean patients.

Methods

This study involved 20 patients (20 eyes) who were treated with SMILE surgery and 23 patients (23 eyes) who were treated with FS-LASIK. The Schirmer test, tear film breakup time (TBUT), corneal staining score (CSS), and measurement of changes in the lipid layer thicknesses at one week, and 1 and 3 months after surgery were performed. Possible correlations between indicators of dry eye syndrome were then analyzed.

Results

There was a significant time difference in some indices. The TBUT was 5.52 ± 1.50 s after one week for SMILE patients and 4.59 ± 2.50 s for FS-LASIK patients (p = 0.02). The CSS was 0.50 ± 0.51 after 1 week for SMILE patients and 1.14 ± 0.99 after 1 week for FS-LASIK patients (p = 0.04). The CSS was 0.50 ± 0.51 after 1 month for SMILE patients and 1.10 ± 0.93 after 1 month for FS-LASIK patients (p = 0.03). Three months later, the CSS was 0.39 ± 0.50 for SMILE patients and 0.94 ± 0.85 for FS-LASIK patients (p = 0.03). However, the Schirmer test did not show a significant difference postoperatively for SMILE and FS-LASIK patients at 1 week (p = 0.44), 1 month (p = 0.68), and 3 months (p = 0.23). Additionally, the thickness of the tear film lipid layer did not show a significant difference during the same periods (p = 0.36, p = 0.43, and p = 0.72, respectively).

Conclusions

When compared with FS-LASIK surgery, SMILE surgery resulted in significantly improved test results in the TBUT and CSS for dry eye syndrome.

Keywords: Dry eye syndrome, Lipiview, keratomileusis, Laser in situ (LASIK), Small incision lenticule extraction (SMILE)

Figures and Tables

Figure 1

Ocular surface parameters after SMILE and FS-LASIK. Ocular surface parameters including Schirmer test, tear break-up time, corneal staining score, lipid layer thickness were compared between patients undergoing SMILE and FS-LASIK. SMILE = small incision lenticule extraction; FS-LASIK = femtosecond laser assisted in situ keratomileusis. ^*p < 0.05 in SMILE, ^**p < 0.05 in FS-LASIK.

Table 1

Demographic characteristics of patients

Values are presented as mean ± standard deviation unless otherwise indicated.

SMILE = small incision lenticule extraction; FS-LASIK = femtosecond laser assisted in situ keratomileusis; M/F = male/female.

^*Student's t-test; ^†Pearson's chi-squared test.

Table 2

Preoperative, 1 week, 1 month, and 3 months after refractive surgery

Values are presented as mean ± standard deviation unless otherwise indicated.

SMT = schirmer test; SMILE = small incision lenticule extraction; FS-LASIK = femtosecond laser-assisted in situ keratomileusis; TBUT = tear film breakup time; CSS = corneal staining score; LLT = lipid layer thickness.

^*Wilcoxon signed-rank test; ^†pair t-test; ^‡Mann-Whitney U test; ^§Student's t-test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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