Effect of hinge width on corneal sensation and dry eye after laser in situ keratomileusis.
OBJECTIVE
To investigate the effect of hinge width on corneal sensation and dry-eye syndrome after laser in situ keratomileusis (LASIK).


METHODS
TLC Laser Eye Center, Garden City, New York, USA.


METHODS
Fifty-four patients at least 18 years of age had bilateral LASIK with a narrow nasal hinge microkeratome flap in 1 eye and a wider nasal hinge microkeratome flap in the other eye. In all eyes, the flaps were 160 microm in thickness with a diameter of 9.5 mm. Masked Cochet-Bonnet esthesiometry was performed in the central cornea preoperatively and at 1 week and 1, 3, and 6 months. Dry eye was evaluated at the same intervals by lissamine green corneal and conjunctival staining, Schirmer test with anesthesia, and tear-film breakup time.


RESULTS
Corneal sensation was significantly reduced from preoperative levels through 6 months in the narrow-hinge group and through 3 months in the wider-hinge group (P< or =.002). The mean corneal sensation was greater in corneas with a wider hinge flap than in those with a narrow hinge flap at all postoperative examinations; the difference was significant at 1 and 3 months (P< or =.002). The loss of sensation was greatest at 1 week and improved at all subsequent examinations. Overall, dry-eye signs and symptoms were greatest immediately postoperatively and improved at subsequent intervals.


CONCLUSIONS
Corneal sensation and dry-eye signs and symptoms improved at all intervals between 1 week and 6 months. The loss of corneal sensation and presence of dry-eye syndrome were greater in eyes with a narrow hinge flap than in eyes with a wider hinge flap.
Donnenfeld
Eric D
ED
Department of Ophthalmology, Nassau University Medical Center, Nassau, NY, USA. eddoph@aol.com
Ehrenhaus
Michael
M
Solomon
Renée
R
Mazurek
Jeremy
J
Rozell
Joshua C
JC
Perry
Henry D
HD
D000328:Adult; D004396:Coloring Agents; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003319:Corneal Stroma / Q000473:pathology*; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008086:Lissamine Green Dyes; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012677:Sensation / Q000502:physiology; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013524:Surgical Flaps; D014787:Vision Tests
D004396:Coloring Agents; D008086:Lissamine Green Dyes