Effect of Carmellose-based Artificial Tears on the Ocular Surface in Eyes After Laser in Situ Keratomileusis

Background: Strategies to minimize intraoperative ocular surface disturbance and accelerate postoperative ocular surface recovery are an important consideration to the surgeon.

Methods: Eighteen eyes of 10 patients were randomized to receive intraoperative and postoperative non-preserved balanced salt solution or non-preserved carboxymethylcellulose-based (carmellose) artificial tears. Presence and severity of McMonnies dry eye symptom survey score primary dry eye symptoms, fluorescein break-up time, and rose bengal staining were graded preoperatively and at 1 day, 1 week and 1 month postoperatively. Conjunctival impression cytology of the perilimbal conjunctiva was performed 1 month after surgery to determine goblet cell density.

Results: McMonnies dry eye symptoms were reported more frequently for the balanced salt solution group at 1 day, 1 week, and 1 month after surgery. Fluorescein break-up time was significantly greater in the carmellose-based group at 1 day (P < .01), 1 week (P = .04), and 1 month (P < .01) after surgery. The rose bengal staining score was significantly greater at 1 day (P < .01) and 1 week (P < .01) postoperatively for the balanced salt solution group. Mean goblet cell density for the carmellose-based group at 1 month postoperatively was significantly greater than that for the balanced salt solution group (P < .01).

Conclusions: Postoperative and intraoperative use of carmellose-based artificial tears resulted in significantly more rapid recovery of the ocular surface after LASIK when compared to balanced salt solution.