Comparison of Short-Term Changes in Dry Eye Indexes between Femtosecond Lenticule Extraction and Small Incision Lenticule Extraction

Abstract

Objective: To compare early changes in dry eye after femtosecond lenticule extraction (FLEx) and small incision lenticule extraction (SMILE). Methods: Twenty-eight subjects (56 eyes) underwent FLEx and 33 subjects (66 eyes) underwent SMILE in this prospective non-randomized study at the Refractive Center of Hainan Eye Hospital and Key Laboratory of Ophthalmology from February to October 2014. Ocular surface disease index (OSDI), Schirmer Ⅰ test (SⅠT), noninvasive tear breakup time (NIBUT), and tear meniscus height (TMH) were evaluated at 1 day, 1 week and 1 month after surgery but corneal fluorescein staining (FL) was measured only at 1 week and 1 month postoperatively in all patients. Concentrations of interleukin-1α (IL-1α) and tumor necrosis factor-α (TNF-α) in collected tears were assessed by multiplex antibody microarray at 1 day, 1 week and 1 month after surgery in both groups. Data were analyzed using repented measured ANOVA. Results: The NIBUT of the FLEx group was shorter than that of the SMILE group (P=0.029) and the FL scores of FLEx were worse than that of the SMILE group (P=0.037) at 1 week after surgery. OSDI scores of both groups were better than baseline levels (all P<0.001). There were no significant changes found in OSDI, SⅠT and TMH between the FLEx and SMILE groups. Higher tear concentrations of IL-1α were found in the FLEx group than that in the SMILE group (P=0.019). There was no significant difference in tear concentrations of TNF-α between the two groups. Conclusions: The early dry eye in the SMILE group was milder than in the FLEx group. Key words: femtosecond lenticule extraction; small incision lenticule extraction; dry eye