Goblet Cell Response and Dry Eye Symptoms After PRK and LASIK

Exclusion Criteria

• •1. Previous surgery or trauma to the study eye.
• •2. Dry eye as reflected by Schirmer's test with anesthesia of 0, subjective complaints or symptoms of dry eye, findings during the slit lamp exam that would be consistent with dry eye (e.g. superficial punctuate keratitis).
• •3. Female subjects who are pregnant, breast-feeding or intend to become pregnant during the study. This is a standard of care exclusion for refractive surgery at the Walter Reed Refractive Surgery Center because of the medications that are routinely given as part of the procedures. Standard of care analgesia consists of medications (e.g. narcotics) labeled as Pregnancy Category "C" by the FDA. Teratogenic effects are not known, however, physical dependence in the neonate may occur if the mother is given narcotics. Female subjects will be given a urine pregnancy test prior to participating in the study to rule out pregnancy.
• •4. Concurrent topical or systemic medications that may impair healing, including corticosteroids, antimetabolites, isotretinoin (Accutane), amiodarone hydrochloride (Cordarone) and/or sumatriptan (Imitrex).
• •5. Medical condition(s), which, in the judgment of the investigator, may impair healing, including but not limited to: collagen vascular disease, autoimmune disease, immunodeficiency diseases, and ocular herpes zoster or simplex.
• •6. Active ophthalmic disease, neovascularization of the cornea within 1mm of the intended ablation zone, or clinically significant lens opacity.
• •7. Evidence of glaucoma or an intraocular pressure greater than 22 mm Hg at baseline.
• •8. Evidence of keratoconus, corneal irregularity, or abnormal videokeratography in either eye.
• •9. History of recurrent erosions or epithelial basement dystrophy.
• •10. Patients with known sensitivity or inappropriate responsiveness to any of the medications used in the post-operative course.
• •11. Any physical or mental impairment that would preclude participation in any of the examinations.