Abstract
There are no international or Chinese guidelines for the management of dry eye disease that develops after corneal refractive surgery. Sodium hyaluronate is the first-line therapy for dry eye diseases but is not sufficient to treat severe conditions. This study aimed to compare three-month outcomes following treatment of dry eyes after corneal refractive surgery with 3% diquafosol against those with 0.1% sodium hyaluronate. In a retrospective study, 118 patients were treated with 3% diquafosol sodium six times/day (DQS cohort, n=118 eyes) and 184 patients were treated with 0.1% sodium hyaluronate four times/day (SH cohort, n=184 eyes) for three months. Before treatments (BT), the ocular surface damage score was between 5 and 9 per eye, the ocular surface disease index was between 64 and 70% per eye, and the subjective symptom questionnaire score was between 13 and 19 per eye. Wet length of Schirmer's I strip test, ocular surface damage score, ocular surface disease index, and subjective symptom questionnaire scores improved in both cohorts after 3 months of treatments (AT) compared to BT conditions (P<0.01 for all comparisons). However, improvement was greater in the DQS cohort than in the SH cohort in the AT condition (P<0.01 for all comparisons). Blurred vision, ocular discomfort, and foreign body sensations were observed in a few cases. Dry eye disease is a common complication after corneal refractive surgery, and there is a lack of international guidelines addressing its management. Three percent diquafosol showed superior improvement of dry eye parameters post-refractive surgery than 0.1% sodium hyaluronate.