Corneal Sensitivity and Some Properties of the Tear Film After Laser in situ Keratomileusis

ABSTRACT PURPOSE: To investigate central corneal sensitivity, lipid layer structure of the precorneal tear film, and tear volume after laser in situ keratomileusis (LASIK). METHODS: Central corneal sensitivity was measured using the Non-Contact Corneal Aesthesiometer. The aesthesiometer was mounted on a slit lamp and an airpulse of controlled pressure was directed onto the cornea. When central corneal sensitivity was reduced, a higher air pulse pressure was required to stimulate the cornea. The final central corneal sensitivity threshold measured was recorded in millibars. Tear lipid layer structure was assessed by optical interferometry and classified according to appearance using the Keeler Tearscope. Tear volume was measured using the phenol red cotton thread test. Subjects were recruited from a group of patients after LASEK who had experienced no complications (n=22). The average postoperative time was 14 weeks and measurements were taken on one eye. In bilateral cases, measurements were recorded from the right eye only. Average attempted correction was -6.30 D (range, -2 to -11 D). Age-matched controls were later recruited for central corneal sensitivity threshold (n=24). A second group of age-matched controls were recruited for tear volume and lipid layer structure (n=24). RESULTS: The median (range) was 1.1 mbars (0.2 to 4.3 mbars) after LASEK and 0.58 mbars (0.20 to 1.3 mbars) in the controls; the difference was statistically significant (P = .043). The lipid layer of the tear film tended to be thinner in eyes after LASEK compared with controls (P = .032). The mean (± SD) tear volume was 16.9 ± 8.3 mm after LASEK and 19.8 ± 7.1 mm in controls. This difference was not statistically significant (P = .492). CONCLUSION: At 14 weeks postoperatively, central corneal sensitivity was below normal levels and the tear lipid layer was thinner. The poorer quality lipid layer may predispose to symptoms of dry eye after LASEK. [J Refract Surg 2001;17:17-24]