Prospective, Randomized Comparison of Self-reported Postoperative Dry Eye and Visual Fluctuation in LASIK and Photorefractive Keratectomy

Purpose We sought to prospectively compare postoperative symptoms of dry eye, visual fluctuations, and foreign body sensation in patients undergoing LASIK and photorefractive keratectomy (PRK). Design Randomized clinical trial. Participants Sixty-eight eyes of 34 patients were treated with wavefront-guided LASIK and PRK. Methods One eye was treated with LASIK and the fellow eye was treated with PRK. Eyes were randomized by ocular dominance. Patients completed a questionnaire preoperatively and at each postoperative visit evaluating symptoms of dry eye, dry eye severity, vision fluctuations, and foreign body sensation. Main Outcome Measures Change in self-reported dry eye with secondary outcome measure of visual fluctuations and foreign body sensation scores after LASIK and PRK. Results Both groups of eyes experienced significant increases in symptoms of dry eye, vision fluctuation, and foreign body sensation after LASIK and PRK at postoperative months 1, 3, and 6. However, by the 12-month postoperative visit, there was no increase in dry eye symptoms over the preoperative baseline levels in either group. Patients undergoing PRK experienced significantly higher levels of vision fluctuation at postoperative month 1 than those undergoing LASIK. Conclusions Both LASIK and PRK caused an increase in dry eye symptoms and severity, vision fluctuations, and foreign body sensation over baseline in the early postoperative period. At postoperative month 1, PRK caused greater vision fluctuations than LASIK. By 1 year postoperatively, all symptoms of dry eye, vision fluctuations, and foreign body sensation returned to their baseline, preoperative levels. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.