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.