Barzilai University Medical Center

77 Research Day 2020 Barzilai University Medical Center 55 THE ASSOCIATION BETWEEN PREOPERATIVE DRY EYE SYMPTOMS AND POSTOPERATIVE DISCOMFORT IN PATIENTS UNDERWENT PHOTOREFRACTIVE KERATECTOMY Boguslavsky II 1 ,Rabina G 2 , Mimouni M 3 , Kaiserman I 1 ,4,5 . 1 Department of Ophthalmology, Barzilai University Medical Center, Ashkelon, Israel. 2 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3 Department of Ophthalmology, Rambam Health Care Campus, Affiliated to the Bruche and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 4 Faculty of Health Science, Ben Gurion University, Be'er Sheva, Israel. 5 Care Vision Laser Refractive Center, Tel Aviv, Israel. Background After Photorefractive Keratectomy (PRK) patients usually experience severe discomfort for several days. Hypothesis Preoperative ocular inflammation due to chronic dry eyes might affect the discomfort after PRK Objectives To investigate the association between preoperative dry eye symptoms and postoperative pain and discomfort after PRK. Methods A retrospective case series of 151 consecutive patients, who underwent myopic PRK in both eyes between 5/2016 and 5/2017. Patients with positive dry eye disease (DED) signs on clinical examination or with known DED were excluded. Patients underwent a subjective evaluation for dry eye symptoms using ocular surface disease index (OSDI) and modified standard patient evaluation of eye dryness (SPEED) questionnaires. One day postoperatively, the patients were evaluated again by a questionnaire of pain, discomfort, photophobia, foreign body sensation, satisfaction with vision, and frequency of usage of anesthetic drops. Results Fifty-two patients had any preoperative dry eye symptoms (OSDI score > 0) compared to 99 nonsymptomatic patients (OSDI score of 0). Postoperatively, the symptomatic dry eye patients suffered significantly more pain than the nondry eye patients ( p =0.02). Thirteen patients had a cumulated modified SPEED score >4 (moderate to severe) in comparison to 138 patients with score of 0-4 (non to mild). Patients with moderate to severe preoperative symptoms suffered more pain ( p =0.006), photophobia ( p =0.005), and epiphora ( p =0.03). No statistically significant difference was seen in postoperative subjective visual quality ( p =0.82) between the two groups. Conclusions Preoperative dry eye symptoms may be associated with postoperative pain, epiphora, and photophobia and thus influence negatively on patient satisfaction with this procedure .