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Tear Function Evaluation in Candidates of Corneal Laser Refractive Surgery for Myopia

Farahi, Azadeh M.D.; Hashemi, Hassan M.D.; Mehravaran, Shiva M.D.; Tavakolizadeh, Sepideh M.D.; Khabazkhoob, Mehdi M.Sc.

doi: 10.1097/ICL.0000000000000015

Objective: To assess the tear function in a young to middle age myopic population and finding possible associations of abnormal tear function with gender and age.

Methods: Dry eye workup was conducted in patients undergoing screening for myopic laser keratorefractive surgery. All patients completed the McMonnies dry eye questionnaire (MQ) and also underwent evaluation of the fluorescein break-up time (FBUT) and the Schirmer tests with anesthesia (STA). Patients with contraindications for keratorefractive surgery or any condition interfering with tear function were excluded from the database.

Results: In this prospective study, we evaluated 655 eyes of 216 women and 116 men with a mean age of 27.3±6.1 years. Results of right eyes only are reported. The FBUT and STA were abnormal in 30.8% (95% confidence interval [CI]: 25.7–35.8) and 14.6% (95% CI 10.7–18.4) of cases, respectively. According to MQ scores, 15.9% (95% CI: 11.8–20.0) of patients showed abnormal results. In the assessment of abnormal cases, MQ scores were significantly higher (P<0.001) and FBUT was significantly lower in women (P=0.003) and older ages. Abnormal STA results were not significantly correlated with age or gender.

Conclusion: In an otherwise normal population seeking keratorefractive surgery for myopia, some cases may demonstrate abnormal tear functions, especially women and older ages. A timely diagnosis and treatment can help avoid complications related to such abnormalities after refractive surgery.

Noor Ophthalmology Research Center (A.F., H.H., S.M., S.T., M.K.), Noor Eye Hospital, Tehran, Iran; and Dezful University of Medical Sciences (M.K.), Dezful, Iran.

Address correspondence to Hassan Hashemi, M.D., Noor Eye Hospital, No 96, Esfandiar Boulevard, Vali’asr Avenue, Tehran 19686-53111, Iran; e-mail:

The authors have no funding or conflicts of interest to disclose.

Accepted December 16, 2013

© 2014 Contact Lens Association of Ophthalmologists, Inc.