Lijuan Wu, Xiaolan Xie, Meihua Lai, Xiaolin Fan, Cuirong Lin
DED is a common but typically transient outcome following FS-LASIK, particularly in female patients and those with preoperative symptoms. Structured preoperative screening, patient counselling, and individualised postoperative care are essential to improving outcomes and minimising patient discomfort. Because follow-up was limited to three months, these findings characterise early postoperative dry eye and do not address long-term persistence.
BACKGROUND: Dry eye disease (DED) is one of the most frequently reported complications following corneal refractive procedures, including femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Despite the advanced precision of femtosecond technology, many patients experience postoperative ocular surface disturbances.
OBJECTIVE: To assess the incidence, severity, and predictive factors of surgery-induced dry eye in patients undergoing femtosecond laser-assisted in situ keratomileusis, through a retrospective analysis.
METHODS: This retrospective study included 3000 patients who underwent FS-LASIK between January 2020 to December 2024. Postoperative DED was defined by the Ocular Surface Disease Index (OSDI, score ≥ 13) at 1 week, 1 month, and 3 months; Schirmer's test was recorded preoperatively and for clinical interpretation only. Statistical analyses included chi-square tests and multivariable logistic regression to identify predictors of DED.
RESULTS: Postoperative DED symptoms were reported in 25% of patients at 1 week, peaking at 38% at 1 month, and declining to 15% at 3 months. Most cases were mild to moderate. Female gender (OR: 2.51, p = 0.003) and preoperative DED (OR: 4.79, p < 0.001) were significant independent predictors of postoperative symptoms. Age did not show a significant association. By three months, the symptoms had significantly improved; however, further monitoring is necessary to assess full recovery and long-term results.
CONCLUSION: DED is a common but typically transient outcome following FS-LASIK, particularly in female patients and those with preoperative symptoms. Structured preoperative screening, patient counselling, and individualised postoperative care are essential to improving outcomes and minimising patient discomfort. Because follow-up was limited to three months, these findings characterise early postoperative dry eye and do not address long-term persistence.