Dry eyes are quite common in pre-operative LASIK patients, but are most often associated with early and late post-operative complications following the procedure.
The number of LASIK patients presenting with varying degrees of pre-operative dry eyes has been estimated to be between 35% and 75%, depending on definition and source, and is now almost universally considered to represent an elevated risk factor for associated post-operative complications.
Evaluating the pre-operative ocular surface is particularly important in managing LASIK patient selection, pre-treatment, optimizing outcomes and improving post-operative patient comfort and satisfaction. In patients presenting with any signs of dry eyes, such as contact lens intolerance, decreased ocular lactoferrin (aqueous deficiency) and secondary allergy related dry eye, current medical standards now suggest the need to assess the pre-operative ocular surface and pre-treat as necessary.
Pre-operative tear lactoferrin levels have been shown to be a statistically significant predictor of post-Lasik refraction.
A low tear lactoferrin level is associated with myopic outcomes and high lactoferrin is associated with hyperopic outcomes. The relationship is linear with normal LASIK outcomes being associated with the previously determined normal range of lactoferrin concentration levels.
The implications for use of quantified tear lactoferrin levels, as part of the routine pre-operative LASIK evaluation, should be significant to the conscientious surgeon.