This study was to study the effect of 0.1% and 0.3% sodium hyaluronic ophthalmic solution on tear film stability and visual quality of dry eye patients after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).

A prospective randomly controlled study was designed.Pre-surgery normal patients were evaluated again at 1 week after FS-LASIK, 60 mild and severe dry eye patients were enrolled from April 2016 to April 2017 in Tianjin Medical University Eye Hospital.Then 0.1% and 0.3% sodium hyaluronate were randomly given in each dry eye group.Ocular surface disease index (OSDI), optical quality analysis system Ⅱ(OQASⅡ), Keratography 5M and corneal staining were performed before operation, 1 week (before instillation and 15, 30, 60, 120 and 180 minutes after instillation), 1 month and 3 months after operation.This study was approved by the Ethic Committee of Tianjin Medical University Eye Hospital (2015KY-04). Informed consent was obtained from all subjects after explanation of the nature and possible consequence of the study.

The 0.3% sodium hyaluronate group was better than 0.1% sodium hyaluronate group in alleviating OSDI score and cornea staining at 3 months in the mild dry eye group (F_group=10.913, P=0.003; P=0.027). Compared with the before operation, the objective scatter index(OSI) was increased at 1 week before instillation and many different time points after instillation in both 0.1% sodium hyaluronate group and 0.3% sodium hyaluronate group, with significant differences between them (all at P<0.05), there was no statistically significant difference in OSI at 1 month and 3 months after surgery compared with before surgery in both 0.1% and 0.3% sodium hyaluronate group.In 0.1% sodium hyaluronic group and 0.3% sodium hyaluronic group, the mean value of total OSI at 1 week after surgery were siginifcantly higher than that before surgery (P=0.046, 0.060). In 0.1% sodium hyaluronate group, the mean values of total OSI at various time points after instillation were not statistically different from that before surgery (all at P>0.05), total OSI at 1 month and 3 months after operation were higher than that before surgery (P=0.047, 0.017); In 0.3% sodium hyaluronic group, the mean value of total OSI at 15, 30, 60 and 120 minutes after instillation were significantly higher than that before surgery (all at P<0.05), and compared with the total OSI before surgery, no statistical differences were found at 1 month and 3 months after operation (P=0.046, 0.667). Significant differences were found in NIBUT avg among different time points in the mild dry eye patients (F_time=2.290, P=0.022). In 0.1% sodium hyaluronic group and 0.3% sodium hyaluronic group, the NIBUT avg at 1 week after surgery were significantly lower than that before operation (both at P<0.05). Compared with the before operation, no significant differences were found at the following 3 hours after instillation in 0.1% sodium hyaluronic group (all at P>0.05). In 0.3% sodium hyaluronic group, the NIBUT avg at 60, 120 and 180 minutes after instillation were significantly lower than that before surgery (P=0.040, 0.047, 0.041), and NIBUT avg at 3 months after operation was significantly lower than that before surgery (P=0.044).

The 0.3% sodium hyaluronic is better than 0.1% sodium hyaluronic in alleviating the OSDI score and cornea staining on the mild dry eye post FS-LASIK, and the tear film stability and related visual quality fluctuated over time after the application of 0.3% sodium hyaluronic.

Sodium hyaluronate; Dry eye; Femtosecond laser-assisted laser in situ keratomileusis; Tear film; Optical quality; Dynamics