I'm back with a question :)

[Betty39]

Hi Glenn,

I haven't posted in awhile...life goes on. I am now 8 months post op lasik. I have what my corneal specialist called "mild dry eye" now. My eyes are much better with the plugs and Restasis, however I still have dry eye symptoms daily ie.mild burning/stinging especially in air conditioned/heated rooms. True enough I can deal with it now, but sometimes the irritation really gets to me. But here's my question: At 8 months can I now assume this is as good as it will get? Or can I expect more gradual healing of the dry eyes? I know some people do have this permanently. I also know that some people are boarderline and this surgery pushes them over the line.
I wonder at my doctor if he saw boarderline dry eye and did not mention it to me before surgery. I know it's unhealthy, but I have sooo much resentment for this doctor. I keep thinking he must have seen some dry eye even though I didn't feel any. And for the money, perhaps he sentenced me to this condition permanently. Like I said, I know it does me know good to think these things, but sometimes I can't help it.
Really my main fear is yes, I can deal with this amount of dry eye, but what happens if when menopause comes (I'm 40 now) this condition gets worse? I don't want to ever be like I was in the beginning.
So I guess I'm asking what are my chances of still healing and having further resolution of my symptoms at this point?
Thanks in advance for your reply :)
Betty

[LasikExpert]

At eight months post Lasik the vast majority of your healing has occurred, but not all. If you read about Lasik flap healing you will see that you are in the final stage of flap healing, but that stage can last up to two years. There are several peer reviewed studies that show corneal nerve density returns to pre-Lasik levels after about three years. Nerve density is not as important as nerve sensitivity, but it is a measurement of how the cornea heals after Lasik.

As much as one may want to blame the surgeon - and that is where blame would be made - it is quite possible that before surgery you demonstrated no clear indication of susceptibility to long-term Lasik induced dry eyes. Even though the incidence of long-term problems is relatively rare, it's 100% when you have it.

There is no reason to abandon hope, and good reason to expect the desired - albeit late - outcome.

And don’t be a stranger. You have become quite knowledgeable about Lasik (probably much more than you desired) and your experiences will be appreciated by others in this forum.

[JPD]

There are several peer reviewed studies that show corneal nerve density returns to pre-Lasik levels after about three years.

I've read that after 5 years for Lasik, 2 years for surface ablations, the nerve density IS back to 100%. Although as you said, that's not as important nerve sensitivity.

Even though the incidence of long-term problems is relatively rare, it's 100% when you have it.

Just curious Glenn, you use this term somewhat frequently but when you say "long-term", do you typically mean permanent? Or do you just mean beyond the range of what's considered "normal". Meaning that at some point in time it will resolve?

Thanks.

[peakaboo]

I'm glad you posted Betty...I was about to ask the same question. i'm 10 months post-lasik and although the Restasis seems to be making a difference, my eyes are still dry when I first wake up. I no longer require drops throughout the day, but I'm curious if this is as good as it gets. My surgeon said that the nerves grow back at about 1mm per month, and my flap was 9.5mm diameter, so using that healing rate, I should be fully healed, but this is obviously not the case. I also wonder what would happen if I stopped taking the Restasis...would this help to kickstart my normal tear function or does it always result in less tear production? I don't want to be hooked on Restasis for the rest of my life, it's an extra $600/year.

[LasikExpert]

JPD, We officially consider any complication unresolved six months postop as "long-term". This does not necessarily mean permanent as many problems resolve after the six month point.

peakaboo, Your major medical insurance should probably be paying for treatment of dry eyes. I recommend you seek an evaluation with your primary care provider and describe your dry eye symptoms.

[peakaboo]

Yes, I'm covered...it a $50 copay (no generic brand available).

[Betty39]

Thanks Glenn for your quick response :) I don't plan on abandoing this board ever, it has helped me so much and even if I am ever 100% complication free, I will still check in from time to time to offer whatever I can to the discussion.
My doctor gave me a prescription for Restasis for 1 year. So I expect he expects me to be on it that long at least. It would be sad, I agree, to have to be on this the rest of our lives. Lucky for me it's a 5 dollar prescription, and because I use one vial for both day and night the prescription lasts me 2 months. I am very lucky in that. But I am spending about 40 bucks a month on the Genteal Gel for night time. This is wayyy more than I was spending on my contact lens solutions, that too is sad.
It would be nice if someday those products wouldn't be necessary. We did this surgery for convenience. So far this has been much more inconvenient than contacts ever were.
Thanks again for all the much needed encouragement!

[LasikExpert]

Over-the-counter artificial tears are as much a part of the treatment of dry eyes as the prescription medication and would probably be covered by your major medical insurance plan. You should check.

[Betty39]

Great idea Glenn...thanks!