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Efficacy of punctal occlusion in management of dry eyes after laser in situ keratomileusis for myopia

机译:准分子激光原位角膜磨镶术治疗近视眼干眼症的疗效

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Purpose: To evaluate the effect of punctal plug use in preventing dry eye after laser in situ keratomileusis (LASIK). Materials and Methods: A randomized clinical trial at a tertiary eye care center, Riyadh, Saudi Arabia. Participants underwent LASIK for myopia in both eyes and a lower punctal occlusion in one eye only while the other eye served as control. Both eyes received the same postoperative medications except for lubricant duration (subject eye: four times per day for one week; control eye: four times per day for 6 months). Participants were evaluated at 1 week, 2, and 6 months after surgery for signs and symptoms of dry eye. The main outcome measures were visual acuity; ocular surface parameters; and Ocular Surface Disease Index questionnaire. Results: Seventy-eight eyes of 39 patients were included in this study. The Ocular Surface Disease Index scores of eyes with punctal plugs were better at all follow-up visits, and the differences between both eyes were statistically significant (1 week, p < 0.0001; 2 months, p < 0.0001; 6 months, p = 0.008). At the final follow-up visit, the percentage of normal eyes was higher in eyes with punctal plugs for all ocular surface parameters (Schirmer 1 test, 94.9%; tear breakup time, 77.8%; punctate epithelial keratitis score, 71.8%) compared to eyes without occlusion (Schirmer 1 test, 92.3%; tear breakup time, 58.3%; punctate epithelial keratitis score, 53.8%); however, such differences were not statistically significant. Conclusion: Punctal plug insertion after LASIK surgeries may minimize the need for frequent lubricant application and hence improve patient satisfaction.
机译:目的:评估使用泪点塞预防激光原位角膜磨镶术(LASIK)后干眼的效果。材料和方法:在沙特阿拉伯利雅得的第三级眼保健中心进行的一项随机临床试验。参与者仅在另一只眼睛作为对照的情况下对两只眼睛进行了LASIK手术以治疗近视,而一只眼睛的泪点闭塞较低。除润滑剂持续时间外,两只眼睛均接受相同的术后药物治疗(受试者眼睛:一周四次,每天四次;对照眼睛:六个月,每天四次)。在手术后第1、2、6个月对参与者进行干眼症状和体征评估。主要结局指标为视敏度。眼表参数;和眼表疾病指数问卷。结果:本研究包括39例患者的78只眼。在所有随访中,泪点塞眼的眼表疾病指数评分均更好,并且两眼之间的差异具有统计学意义(1周,p <0.0001; 2个月,p <0.0001; 6个月,p = 0.008 )。在最后一次随访中,所有眼表参数的泪点塞眼中正常眼的百分比更高(Schirmer 1测试为94.9%;泪液破裂时间为77.8%;点状上皮角膜炎得分为71.8%)。无闭塞的眼睛(Schirmer 1测试,92.3%;泪液破裂时间,58.3%;点状上皮角膜炎评分,53.8%);但是,这种差异在统计上并不显着。结论:LASIK手术后插入泪点塞可以最大程度地减少频繁使用润滑剂的需求,从而提高患者满意度。

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