Combination Therapy with Diquafosol Tetrasodium and Sodium Hyaluronate in Patients with Dry Eye after Laser In Situ Keratomileusis – Accepted Manuscript

Abstract: Purpose: To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK).Design: Prospective, randomized, comparative trialMethods: A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to one of four treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. A questionnaire for subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear breakup time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK.Results: Distant uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distant functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with that in the other groups 1 week after surgery.Conclusions: Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK.