title: The effect of punctal occlusion on wavefront aberrations in dry eye patients after laser in situ keratomileusis.
abstract: OBJECTIVE
  To compare the wavefront aberrations in post-laser in situ keratomileusis (LASIK) dry eye patients before and after punctal occlusion.
  
  
  METHODS
  Prospective, comparative, nonrandomized study.
  
  
  METHODS
  Wavefront aberrometry was performed on 16 eyes of eight patients with dry eyes after LASIK surgery. Wavefront measurements were taken before and 1 month after punctal plug placement and compared with 10 eyes of post-LASIK patients without clinically dry eyes measured twice 1 month apart. Student t tests were used to assess the statistical significance of differences between pre- and post-punctal plug measurements.
  
  
  RESULTS
  Punctal occlusion in the post-LASIK dry eye patients significantly reduced total, lower, and higher order wavefront aberrations by 47% to 63% (P <.01). Among higher-order aberrations, there were significant reductions in coma and spherical aberration but not in trefoil, after punctal occlusion. The reduction of wavefront aberrations by punctal occlusion in post-LASIK dry eye patients resulted in a significant improvement in quantitative visual acuity assessed using an Early Treatment of Diabetic Retinopathy Study chart and in subjective qualitative vision, confirmed by convolutional analysis using image simulation. No statistically significant differences in any of these metrics were found in the post-LASIK control group without clinically dry eyes measured twice at a similar time interval.
  
  
  CONCLUSIONS
  Wavefront aberrometry provides a useful, objective assessment of post-LASIK dry eye patients before and after punctal plug placement. Aggressive treatment of dry eyes may be important before obtaining wavefront measurements that serve as the basis for planning refractive corneal laser treatments and retreatments.
authors.affiliation: Pepose Vision Institute, St. Louis, Missouri, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Huang
authors.forename: M Azim
authors.initials: MA
authors.lastname: Mirza
authors.forename: Mujtaba A
authors.initials: MA
authors.lastname: Qazi
authors.forename: Jay S
authors.initials: JS
authors.lastname: Pepose
mesh_terms: D000328:Adult; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D007765:Lacrimal Apparatus / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology*; D054140:Refractive Surgical Procedures; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology