There was no difference in the post-op dry eye complaints, number of visits or refraction and visual acuity outcomes between patients with clinically significant MGD and those without it. Photo: Kambiz Silani, OD. Click image to enlarge.
It has been widely reported that patients with preoperative dry eye disease undergoing LASIK are at an increased risk for worsening of symptoms and regression of visual acuity and refraction. However, it is not known whether patients with asymptomatic dry eye–related findings, such as meibomian gland dysfunction (MGD), are at risk for inferior LASIK outcomes and increased risk of postoperative dry eye signs and symptoms. A recent study in Ophthalmology and Therapy noted that clinically significant asymptomatic preoperative MGD did not have a significant impact on LASIK outcomes.
The researchers included a total of 497 eyes of patients who underwent LASIK refractive surgery and evaluated the impact of preoperative MGD on postoperative dry eye and surgical outcomes after one month. Both patients and controls had similar rates of punctate epithelial erosions (12.9% vs. 14.8%), post-op complaints of dryness (32.3% vs. 34.2%) and post-op number of visits (3.15 vs. 3.12). Uncorrected visual acuity (logMAR) at one month (0.026 vs. 0.026) after surgery was also similar in both groups. Mean spherical equivalent was 0.03 and -0.03 in patients and controls, respectively. Safety index was 1.02 in the clinically significant MGD group and 1.03 in the control group. Efficacy index was also similar between both groups (0.966 and 0.979, respectively). No differences were found between patients with myopia and hyperopia.
Nevertheless, the researchers still recommend a thorough preoperative evaluation and postoperative management of refractive surgery candidates with dry eye in the initial screening and during follow-up examination. However, in asymptomatic patients, “no specific preoperative treatment or special caution is needed in these cases.”
Spierer O, Nemet A, Bloch S, et al. The effect of meibomian gland dysfunction on laser-assisted in situ keratomileusis in asymptomatic patients. Ophthalmol Ther. November 8, 2022. [Epub ahead of print].