Impact of Dry Eye Disease on Visual Function and Quality after Femtosecond LaserAssisted In-Situ Keratomileusis

Purpose: The purpose of this study was to determine how objective and subjective parameters of dry eye disease correlate with objective vision quality changes following femtosecond laser in-situ keratomileusis (FS-LASIK) surgery in low and high myopes. Methods and Materials: This prospective, observational case series recruited patients undergoing bilateral FS-LASIK. Patients were divided into low/moderate and high myopia groups based on pre-operative assessment. Objective and subjective measurements of dry eye, as well as measurements of vision quality were obtained pre-operatively, 1-week, 1 month, and 3 months post-operatively. Thirty patients were included. The low/moderate and high myopia groups each contained 15 patients. Results: Non-invasive keratography tear break up time (NIKBUT) decreased after FS-LASIK in both groups. Objective scatter index (OSI) improved in the L/M myopia group but worsened in the H myopia group post-operatively. Modulation transfer function (MTF) cutoff improved in both groups post-operatively. A negative correlation was identified between the NIKBUT and both the OSI and MTF results. Changes in ocular surface disease index (OSDI) scores support these objective findings. Conclusion: The results of our study provide evidence that ocular surface changes associated with dry eye contribute to reduced subjective vision quality after FS-LASIK. Refractive surgeons should address dry eye pre-operatively and manage its sequalae post-operatively.