Superficial Punctate Keratopathy after LASIK

ABSTRACT

PURPOSE: To evaluate the clinical characteristics of superficial punctate keratopathy following LASIK and to estabilish the management and prevention of superficial punctate keratopathy. METHODS: We retrospectively analyzed the medical records of 476 eyes followed up for more than 6 months after LASIK. RESULTS: Of the 476 eyes, the SPK has deveolped in 118 eyes (24.8%). The incidence was higher when there was a history of dry eye symptoms or contact lens intolerance (p<0.05%). In 68 eyes (57.6%), SPK has developed within 1 month after LASIK and the inferior cornea (85.6%) was the most frequently involved site. Most cases were asymptomatic and treated with preservative-free artificial tear solution. There were no visually significant complications. CONCLUSIONS: Corneal sensitivity decreases after LASIK by cutoff of the sensory innervation. As LASIK-induced neurotrophic epitheliopathy has an influence on tear film dynamics, it may be a possible cause of dry eye syndrome or epithelial keratopathy after LASIK. Careful attention should be taken into the contributing factors such as pre-existing dry eye syndrome, contact lens intolerance, previous history of blepharoplasty, lagopthalmos and so on. Adequate hydration of cornea preoperatively, careful manipulation during procedure, conservative treatment with artificial tears may be helpful in reducing symptoms and preventing further complications.