title: Evaluation of dry eye after femtosecond laser-assisted cataract surgery.
abstract: OBJECTIVE
  To compare dry-eye signs and symptoms after femtosecond laser-assisted cataract surgery and conventional phacoemulsification.
  
  
  METHODS
  Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
  
  
  METHODS
  Prospective consecutive nonrandomized comparative cohort study.
  
  
  METHODS
  Consecutive patients who had femtosecond laser-assisted or phacoemulsification cataract surgery were assessed. Dry-eye markers including the ocular surface disease index (OSDI) and subjective symptom questionnaire, tear-film assessment using Keratograph 4 corneal topography, Schirmer testing I, and fluorescein staining were sequentially evaluated preoperatively and postoperatively at 1 day, 1 week, and 1 month.
  
  
  RESULTS
  The study recruited 137 eyes (137 patients) with similar baseline characteristics. Most patients developed dry eye postoperatively. Subjective symptoms and fluorescein staining scores elevated from baseline, tear breakup time and Schirmer testing I values decreased postoperatively, which peaked at 1 week and did not return to baseline within 1 month. There were no significant differences between the 2 groups (all P > .05) except for a higher fluorescein staining score in the femtosecond group at 1 day (P = .001), 1 week (P = .047), and 1 month (P = .025). OSDI score and subjective symptoms were greater in the laser group at 1 week (P = .014 and P = .016, respectively). Subgroup analysis showed obvious worsening by fluorescein staining at 1 day (P = .016) and 1 month (P = .009) in preoperative dry-eye patients.
  
  
  CONCLUSIONS
  Both methods worsened dry eye postoperatively. Femtosecond-assisted surgery had a higher risk for staining and dry-eye symptoms. Patients with preexisting dry eye who had femtosecond-assisted surgery had more severe ocular surface staining than those having conventional surgery.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Yinhui
authors.initials: Y
authors.lastname: Yu
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Huixia
authors.initials: H
authors.lastname: Hua
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Menghan
authors.initials: M
authors.lastname: Wu
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Yibo
authors.initials: Y
authors.lastname: Yu
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Wangshu
authors.initials: W
authors.lastname: Yu
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Kairan
authors.initials: K
authors.lastname: Lai
authors.affiliation: From Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China. Electronic address: xlren@zju.edu.cn.
authors.forename: Ke
authors.initials: K
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D019781:Corneal Topography; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011795:Surveys and Questionnaires