title: Comparison of dry-eye disease severity after laser in situ keratomileusis and laser-assisted subepithelial keratectomy.
abstract: OBJECTIVE
  To evaluate the effects of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) on dry-eye disease markers including tear osmolarity, Schirmer testing, and the ocular surface disease index (OSDI).
  
  
  METHODS
  Laser Suite, Mater Private Hospital, Dublin, Ireland.
  
  
  METHODS
  Prospective controlled cross-sectional observation study.
  
  
  METHODS
  In a single center, consecutive eyes that had LASIK or LASEK had dry-eye disease markers assessed preoperatively and 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  In LASIK eyes (n = 50), the mean tear osmolarity was significantly elevated (by 2.8%) at 12 months (P=.009, Student t test). The mean Schirmer test values were not significantly altered postoperatively in either group. The mean OSDI was maximum in LASIK eyes at 3 months (mean follow-up 7.2 months ± 8.2 [SD]) and in LASEK eyes (n = 35) preoperatively (mean follow-up 9.1 ± 9.7 months).
  
  
  CONCLUSIONS
  There were no significant differences in dry-eye disease markers or tear osmolarity between LASIK and LASEK patients at any stage after surgery up to 1 year. Although tear osmolarity remains one of the highest predictive tests of dry eye, it is complementary with other diagnostic criteria in the context of dry eye after refractive surgery.
authors.affiliation: Laser Suite, Mater Private Hospital, Dublin, Ireland.
authors.forename: Ian
authors.initials: I
authors.lastname: Dooley
authors.forename: Fiona
authors.initials: F
authors.lastname: D'Arcy
authors.forename: Michael
authors.initials: M
authors.lastname: O'Keefe
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015352:Dry Eye Syndromes / Q000145:classification / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D009994:Osmolar Concentration; D011446:Prospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D013666:Tears / Q000737:chemistry / Q000378:metabolism; D055815:Young Adult