A Multi-Center Study of the Prevalence of Dry Eye Disease in Chinese Refractive Surgery Candidates.

OBJECTIVE To determine the prevalence of preoperative dry eye disease and evaluate tear film function in refractive surgery candidates in China. METHODS In this prospective noninterventional cross-sectional study, refractive surgical candidates from 13 pre-selected eye hospitals in China were recruited from July 2015 to February 2016. Patient histories, subjective symptoms, tear film breakup time (TBUT), ocular surface fluorescein staining, and Schirmer I tests (SIT), were assessed to conduct subgroup analysis. RESULTS A total of 1849 patients were recruited, 41.4% were diagnosed with dry eye disease (766/1849) and 44.9% (830/1849) of subjects had a positive history of contact lens wear. The overall mean TBUT and SIT values were 7.3 ± 3.7s and 15.2 ± 8.8mm, respectively. The total prevalence of ocular surface fluorescein staining was 23.46% (422/1849). 44.62% of patients had TBUT <5s, 23.20% of patients had SIT <5mm. Contact lens wearers were observed to have a higher prevalence of dry eye than non-contact lens wearers (54.1% vs 35.2%, OR=2.17, 95%CI: 1.77-2.65). CONCLUSIONS In this study, the most common abnormal finding in dry eye disease was tear film instability. A high proportion of refractive surgery candidates have preexisting dry eye disease and a history of contact-lens wear prior to surgery. Careful attention should be given to the evaluation of preoperative dry eye in refractive surgery candidates.