By Ericka Glaze Olazo, student of the Master in Clinical Optometry and Vision Therapy

Abstract

This systematic review and meta-analysis evaluated the incidence, severity, and risk factors associated with dry eye following Laser-Assisted In Situ Keratomileusis (LASIK) surgery. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases including PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were systematically searched for studies published between 2000 and 2025. Studies involving human participants undergoing LASIK surgery and reporting postoperative dry eye outcomes were included. Outcomes assessed included Tear Break-Up Time (TBUT), Schirmer test values, Ocular Surface Disease Index (OSDI) scores, corneal fluorescein staining, and incidence of chronic postoperative dry eye.
Eleven studies involving approximately 2,450 LASIK patients met the eligibility criteria and were included in the qualitative and quantitative synthesis. Random-effects meta-analysis demonstrated reduced postoperative tear film stability with pooled TBUT values of 6.47 seconds (95% CI: 3.52–9.41), pooled Schirmer test values of 16.41 mm (95% CI: 10.80–22.02), and pooled OSDI scores of 21.90 (95% CI: 1.41–42.39). The pooled incidence of chronic post-LASIK dry eye was 7.31%. Significant heterogeneity was observed among included studies (I² = 72%–96.6%). Frequently reported risk factors included female sex, preexisting dry eye disease, prolonged contact lens wear, autoimmune disease, and surgical variables such as flap thickness and hinge position.
The findings demonstrate that LASIK surgery is associated with measurable postoperative ocular surface alterations and persistent dry eye symptoms in a subset of patients. The study highlights the importance of comprehensive preoperative screening, patient counseling, and postoperative ocular surface management.

Keywords: LASIK surgery, Post-LASIK dry eye, Tear film instability, Ocular surface disease, Refractive surgery complications, Systematic review, Meta-analysis.

Download the full Research Work: Olazo, E. G. (2026). Incidence, Severity, and Risk Factors of Dry Eye After LASIK Surgery: A Systematic Review and Meta-Analysis. SAERA