Dry Eye/Microstriae

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Dry Eye/Microstriae

Postby DryEye » Tue Jun 20, 2006 5:09 pm

Had custom lasik beginning of June (prelasik astigmatism and something like -3 for vision on my contacts). Received a second opinion on my lasik after being evaluated with microstriae. I also seem to have a slight ghost in one eye while viewing VCR clock and green stoplights in distance. First doc who performed wanted to lift flaps, but suggested that we get another opinion. The second (at a major hospital/teaching center) said to use Refresh drops every 1/2 hour, Systane preservative free drops and Restasis (twice a day) - No flap lifts needed. At time vision is perfect while other times not totally clear and crisp. After using Systane vision does become clear and crisp. Will this resolve itself without the use of Restasis overtime and just using Refresh drops and Systane? I am not a big fan of Restasis after reading the literature on it. Vision is almost there, but it is off enough in clarity & consistency that it is noticeable.
Nice website!
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Postby LasikExpert » Tue Jun 20, 2006 7:48 pm

It appears that you have two separate, but interrelated, problems.

Striae is a wrinkle in the Lasik flap. There are two kinds of striae; macrostriae and microstriae. Macrostriae are large folds in the flap, like a rumpled comforter on a bed. Microstriae are small crinkles within the flap, like crumpled sheets under that comforter.

As a general rule, macrostriae needs attention sooner rather than later. The common response is to lift the flap, smooth the wrinkles, and reposition the flap. Microstriae is commonly better left alone. Microstriae tend to resolve on their own with healing. We have a detailed article about both types of striae at Lasik Striae Wrinkles

The fact that your eyes sometimes have good vision quality indicate that your vision problems are also related to Lasik induced temporary dry eye.

During Lasik the nerves that tell you your eyes are dry and that regulate the normal tearing function are disrupted. This causes two problems. One is that you really don’t know when your eyes are dry until they are pretty darn irritated. The others is that your eyes are likely to be dry because of tearing deficiency. A good regime of preservative-free artificial tears can maintain healthy eyes while you heal from surgery. This problem is commonly temporary and usually resolves within the normal six month healing period. We have a detailed article on Lasik Dry Eye Treatment.

Restasis is an anti-inflammatory eye drop. The fluids that comprise tears travel down tiny channels. If there is inflammation around those channels, they are squeezed closed and the fluids do not arrive at their destination. Restasis can reduce the inflammation that is closing the channels that carry the fluids required for good tear film quantity and good tear film quality. A problem with Restasis is that it does not reach full effectiveness until after about three months of use. You may receive benefit before then, but it will not be the full benefit.

Lasik induced temporary dry eyes and microstriae can both provide poor vision quality, however both commonly resolve with healing. You need to seek the care of your doctor and follow his or her advice for methods to promote healing and hasten resolution.
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Postby boston » Tue Feb 05, 2008 5:29 am

Hey guys, Will Lasik induced dry eye continue to improve still even 7 months post-op?
It is middle of winter, Febuary in Boston, and dry right now. My eyes bother me a bit, and have been for a few weeks now. I went in to have them checked out today, and they say things are ok and just "winter nusance drying" or something, and just to use drops. Its a little bothersome. I had the surgery 7 months ago..

Will this continue to be a problem EVERY winter?? :cry:

Any advice!?

Thanks folks!

Ben, in Boston
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Postby DryEye » Tue Feb 05, 2008 9:03 pm

It probably will
Mine got better at the 6 month point, 12 month point and noticed of late it is better - I am 20 months out
I never used Restasis - just Tons of TheraTears, which overtime subsided in the amounts per day.
If you got the on the money refractive correction consider yourself lucky in that by summertime and year-end it should be much better
It's too bad that the industry down plays this because I imagine that for some it is debilitating, especially for those that live in desert states (arizona, nevada, etc.).
I wish I knew of this site and all I learned along the way
I would've have chosen only a TOP surgeon, so I could have avoided all the problems I encountered
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Hi Dryeyes

Postby snowprince » Mon Mar 17, 2008 3:54 pm

Dear Dryeyes, I am about 2.5 months post lasik and I am having similar ghost image on green stop lights when i see them at a distance.

One qn: Has your ghosting of green stoplights resolved?

I am very worried. Thanks
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Joined: Thu Feb 07, 2008 2:46 am

Postby DryEye » Mon Mar 17, 2008 4:00 pm

They got better around the 6 month mark, but I still see them at times.
Mine may be due to residual astigmatism?
I may go back and get one eye done only this time by a Top Surgeon and then decide on the other.
If you haven't seen a corneal specialist I would along with a Top refractive surgeon (the one I went to is in Kansas).
Both can give you piece of mind in order to make a better decision down the road.
If you are only 2 1/2 months things will probably get better for you - keep up the preservative free artificial tears and seriously consider another opinion if you feel you aren't being heard/listened to by your current doctor(s).
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Postby snowprince » Tue Mar 18, 2008 3:29 pm

Thanks dryeye!
your words are so encouraging.
I must say there has been some gradual, almost unnoticeable improvements in my vision. BUT TOO SLOW!! TOO SLOW!!

I hope this continues and I will update u accordingly.
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