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The most common postoperative complication of laser vision correction is keratoconjunctivitis sicca, or dry eye. Inconsistencies in the literature make it unclear whether LASIK or PRK results in higher rates of dry eye. We explored the proportion of dry eye interventions during the first postoperative year to evaluate the incidence of dry eye.
Performing a retrospective chart review of all LVC patients between 2009-2019 at a private Boston ophthalmology clinic, the proportion of patients that required postoperative dry eye interventions within the first 12 months following surgery was quantified. All patients outside these parameters were excluded otherwise there was no additional inclusion criterion. At this clinic, a dry eye intervention was defined as either punctal plug insertion and/or prescription medication (Xiidra or Restasis) use. The total number of eyes operated on was 11,175 LASIK eyes from 5,920 individuals, 1,549 LASEK eyes from 880 individuals, and 2,006 PRK eyes from 1,165 individuals.
Comparing the proportion of LASIK dry eye interventions to the proportion of PRK/LASEK dry eye interventions via a 2-sample z-test at an alpha level of significance of 0.05, yielded z = 5.7 and a p-value= <0.0001 at a 95% CI (0.0102 - 0.0208) (Sergeant, 2018).
Our results suggest a greater incidence of postoperative dry eye interventions for PRK/LASEK patients compared to LASIK patients in the 12 months following LVC surgery. This study should help surgeons in deciding which LVC surgery to recommend in order to reduce postoperative dry eye incidence and improve overall patient quality of life.