Analysis quantitative and qualitative of the tear film in patients
                    undergoing PRK and LASIK with femtosecond

Leite, Rubens Amorim; Nosé, Ricardo Menon; Daga, Fábio Bernardi; Lui, Tatiana Adarli Fioravanti; Lui, Giovana Arlene Fioravanti; Lui-Netto, Adamo

doi:10.5935/0034-7280.20140059

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• Rev. bras. oftalmol. 73 (5) • Sep-Oct 2014 • https://doi.org/10.5935/0034-7280.20140059 copy

Analysis quantitative and qualitative of the tear film in patients undergoing PRK and LASIK with femtosecond

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose:

To evaluate tear film stability, ocular surface staining and tear secretion in patients undergoing PRK and femtosecond laser LASIK.

Methods:

Twenty eyes of 10 patients submitted to femtosecond laser LASIK and 11 eyes of the 6 patients submitted do PRK underwent tear film break-up time (TBUT), Schirmer’s basal and lissamine green staining measurements pre and postoperatively on days 15 (PO 15) and 30 (PO 30).

Results:

When grouping all eyes TBUT was reduced on PO 15 (p=0.025) and on PO 30 (p=0.001) compared to preoperative values. No difference was found between PO 15 and PO 30 (p=0.219). Compared to preoperative measurements, lissamine green test demonstrated a significant increase in score on PO 15 (p=0.021) and a significant reduction on PO 30 (p=0.010), when both groups were analyzed together (all 42 eyes). No changes in Schirmer’s basal test were detected in all 3 time periods (p=0.107). TBUT, lissamine green and Schirmer’s basal measurements were no different in all 3 time periods when both groups (PRK and femtosecond laser LASIK) were compared.

Conclusion:

TBUT and lissamine green measurements were altered after refractive surgery regardless the technique (PRK or femtosecond laser LASIK). When comparing one technique to the other, no difference was found in all measurements.

Dry eye syndromes; Tears; Refractive surgical procedures; Keratomileusis, laser in situ; Corneal surgery, laser; Photorefractive keratectomies

	PRK	LASIK	Total	p-value
Genre (n%)
Female	5 83.3	7 70.0	12 75.0	>0.999^a a Fisher’s exact test,
Male	1 16.7	3 30.0	4 25.0
Total	6 100.0	10 100.0	16 100.0
Age (years) 0
N	6	10	16	0.728^b b Student’s t-test for independent samples.
Mean	33.7	32.1	32.7
Median	33.5	32.0	32.0
Minimum	26.0	22.0	22.0
Maximum	45.0	52.0	52.0
Standard-deviation	7.6	9.0	8.3

	Time	Mean ± Standard deviation	Range	p - Value^c c ANOVA with blocks,	p-Value^d d Multiple comparisons using the LSD method
TRFL	pre	13.2 ± 3.3	8,0 - 18.0		0.025^* * Comparison between Pre and 15 PO;
	15 PO	11.3 ± 4.4	4,0 - 20.0	0.003	0.219^ Comparison between 15 PO and 30 PO;
	30 PO	10.4 ± 3.2	6,0 - 16.0		0.001^* ***** Comparison between Pre and 30 PO.
Lissamine	pre	1.0 ± 0.9	0,0 - 3.0	0.019	0.021^* * Comparison between Pre and 15 PO;
	15 PO	1.3 ± 1.0	0,0 - 3.0		0.010^ Comparison between 15 PO and 30 PO;
	30 PO	1.0 ± 1.0	0,0 - 3.0		0.768^* ***** Comparison between Pre and 30 PO.
Schirmer	pre	17.6 ± 10.6	0,0 - 35.0	0.107	-
	15 PO	14.5 ± 10.8	0,0 - 35.0		-
	30 PO	16.2 ± 11.0	0,0 - 35.0		-

Test	Teme	PRK	LASIK	p-Value
TRFL	pre	12.7 ± 2.8	13.4 ± 3.5	0.744^c c p-value for the comparison between PRK and LASIK using ANOVA with repeated measures
	15 PO	10.5 ± 3.1	11.8 ± 5.1
	30 PO	10.8 ± 3.0	10.2 ± 3.4
Lissamine	pre	1.5 ± 0.9	0.8 ± 0.9	0.093^c c p-value for the comparison between PRK and LASIK using ANOVA with repeated measures
	15 PO	1.7 ± 0.9	1.1 ± 1.0
	30 PO	1.4 ± 1.1	0.8 ± 0.9
Schirmer	pre	15.9 ± 10.4	18.6 ± 10.9	0.394^c c p-value for the comparison between PRK and LASIK using ANOVA with repeated measures
	15º PO	11.9 ± 7.1	16.1 ± 12.5
	30 PO	13.8 ± 6.9	17.7 ± 12.9

Sociedade Brasileira de Oftalmologia Rua São Salvador, 107 , 22231-170 Rio de Janeiro - RJ - Brasil, Tel.: (55 21) 3235-9220, Fax: (55 21) 2205-2240 - Rio de Janeiro - RJ - Brazil
E-mail: rbo@sboportal.org.br

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[1] Correspondência com o autor: Rubens Amorim Leite, Rua Doutor Diogo de Faria, no85, apto 72, Vila Clementino, São Paulo, Brazil. Phone: (11) 98568-5500. E-mail: rubensamorim1@hotmail.com