Patients who underwent small incision lenticule extraction had a lower incidence of post-refractive surgery dry eye disease when compared with patients who underwent LASIK surgery, according to recent research.
“Today, a better understanding of the mechanisms involved in the pathogenesis of post-refractive dry eye disease is a crucial issue for two main reasons,” Alexandre Denoyer, MD, PhD, and colleagues wrote in their study published in Ophthalmology.
“First, this should better define the severity and impact of this common surgically induced disease on quality of life, further contributing to the development and evaluation of innovative refractive procedures such as [small incision lenticule extraction] SMILE,” they said. “Second, this should determine the risk factors for surgically induced dry eye, further making indications evolve according to the procedure and preoperative condition of the ocular surface.”
Denoyer and colleagues analyzed the postoperative results of 30 patients who underwent bilateral myopic SMILE and compared them with results from 30 patients who underwent LASIK surgery.
While there was a high rate of mild to moderate dry eye disease 1 month postoperatively in both groups, the LASIK group had a significantly higher rate of dry eye disease after 6 months, according to the study. The researchers found significantly better corneal sensitivity in the SMILE group at 1-month follow-up before the LASIK group reached a statistically similar level of sensitivity at 6 months.
When analyzing patients using in vivo confocal microscopy, the researchers found the SMILE group had significantly higher number of branchings, number of long fibers and corneal nerve density compared with the LASIK group at 1-month and 6-month follow-up.
“The SMILE procedure has a less pronounced impact on the ocular surface and corneal innervation compared with LASIK, further reducing the incidence of dry eye disease and subsequent degradation in quality of life after refractive surgery,” they concluded. – by Jeffrey Craven
Disclosures: Denoyer is a consultant for Alcon, Thea, Abbott Medical Optics and Bausch + Lomb. Baudouin is board member and consultant for Alcon, Allergan, MSD, Thea and Santen.