A comparison of the effect of refresh plus and bion tears on dry eye symptoms and ocular surface health in myopic LASIK patients.
OBJECTIVE
To compare the effect of artificial tears (0.5% carboxymethylcellulose [CMC] in lactate buffer vs. 0.3% hydroxypropyl methylcellulose and 0.1% dextran in bicarbonate buffer [HPMC]) on the preservation of ocular surface health in postoperative laser in situ keratomileusis (LASIK) patients.


METHODS
Nonrandomized, comparative, retrospective analysis of a clinical database. Patients (n = 519; 985 eyes) had undergone LASIK in a single refractive surgery center performed by a single surgeon using the same LASIK technique (Nidek EC5000 laser and ACS keratome). Patients (n = 254) were given CMC (Refresh Plus/Cellufresh) or HPMC (Bion Tears) four times per day and were evaluated at presurgery, week 2, and months 1, 3, and 6. Included patients were those with complete clinical data through the month I follow-up visit.


RESULTS
There were no significant between-group differences in any baseline variable. Following LASIK, fewer CMC patients (n = 111) reported dry eye symptoms than HPMC patients (n = 143) at the week 2 (13.5% vs. 30.8%; P = .001) and month 1 (19.8% vs. 38.5%; P = .001) follow-up visits. CMC patients also had significantly lower mean ocular surface staining scores than HPMC patients at week 2 (0.09 vs. 0.30; P = .015) and month 1 (0.05 vs. 0.28; P = .008). There were no between-group differences in either measure at months 3 or 6 (P < or = .728).


CONCLUSIONS
CMC was more effective than HPMC in controlling dry eye symptoms and preserving ocular surface health in the immediate postoperative period in myopic post-LASIK patients, possibly due to the greater muco-adhesive properties of CMC. These results warrant further investigation as to the most effective postoperative LASIK lubricant.
Albietz
Julie M
JM
Queensland University of Technology, Brisbane, Australia. julie@darkoptics.com.au
Lenton
Lee M
LM
McLennan
Sue G
SG
Earl
Melissa L
ML
D000328:Adult; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D003287:Contrast Media; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005123:Eye / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D019793:Fluorescein; D006304:Health Status; D006801:Humans; D065347:Hypromellose Derivatives; D015994:Incidence; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008747:Methylcellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000737:chemistry / Q000627:therapeutic use*; D012189:Retrospective Studies; D013194:Staining and Labeling; D013499:Surface Properties; D016896:Treatment Outcome
D003287:Contrast Media; D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; D008747:Methylcellulose; D002266:Carboxymethylcellulose Sodium; D019793:Fluorescein