Early changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy

Abstract

Purpose: To investigate the changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy (LASEK). Setting: Department of Ophthalmology, University of Graz, Graz, Austria. Methods: Laser-assisted subepithelial keratectomy was performed in 21 consecutive patients (37 myopic eyes). The patients were observed for subjective complaints of dry eye, corneal sensation, tear-film breakup time (BUT), Schirmer test without local anesthesia, and fluorescein and lissamin-green staining preoperatively and 1 week and 1, 3, and 6 months postoperatively. Results: The subjective score for dry-eye symptoms was not statistically significantly higher after the procedure. Corneal sensation was reduced up to 1 month after LASEK ( P<.05). There were obvious decreases in BUT at 1 week and 1 month ( P<.01) and no significant changes in Schirmer test results. In fluorescein staining of the cornea, dots were more concentrated at 1 week ( P<.05). In lissamin-green staining, no significant changes were found at any follow-up examination. Conclusions: Laser-assisted subepithelial keratectomy induced a short-term reduction in corneal sensation and affected the ocular surface and tear film slightly. Epithelial flap repositioning in LASEK may have a positive influence on tear-film and ocular-surface factors.