Persistent inflammation after PRK

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Persistent inflammation after PRK

Postby zambitte » Mon Jun 26, 2006 5:18 am

My wife had PRK on both eyes a month ago, and her eyes are still under inflammation, which leads to double vision and other disturbances.

Can it be due to dry eyes? She is under an allergy treatment (vaccine) and having birth control pills.
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Postby LasikExpert » Mon Jun 26, 2006 4:46 pm

I’m sorry to of your wife's difficulties. This is something she can expect to resolve.

PRK seems to have a stronger wound healing response then Lasik. That response may include poor vision, inflammation, and a relatively slow recovery. Lasik “fools” the cornea so it does not realize it has had surgery. This dramatically changes the wound response.

Dry eyes, whether they be caused by the surgery or from other sources, can slow healing, reduce vision clarity, cause inflammation (edema), and make the eye very uncomfortable. When the eyes are dry, each blink or movement of the eyes when the eyelids are closed can damage the epithelium. The epithelium is the outermost layer of the cornea and was removed for PRK. These are the fastest reproducing cells in the human body however they do not reproduce well in a dry environment. Those that are reproduced can be damaged and destroyed in a dry environment.

A common side effect of allergy medication is dry eyes. A possible complication of birth control pills is to contribute to dry eyes, however if your wife was using birth control and before surgery and did not experience dry eyes then this is not likely contributing to the problem. During PRK surgery the nerves that regulate tear production are disrupted and this can cause dry eyes. Everyone heals differently and it is difficult to predict how quickly nurse sensitivity will return, however the vast majority of refractive surgery patients have temporary induced dry eye resolved within the normal six-month healing..

The good news is that the issues that are most probably contributing to the problem are temporary. Eventually your wife will not require her allergy medicine. Eventually the corneal nerves sensation will return. Eventually the tearing function will find the balance necessary for proper lubrication. It is possible, but not very probable, that the dry eyes will not resolve within the normal six-month healing period. If it is the case your wife will need to maintain and artificial tear lubrication regime.

What is necessary is for your wife to start a regime of eye lubrication now. We have a detailed article about PRK Dry Eye Treatment that will provide many techniques to resolve dry eye.

Your wife should be using preservative free artificial tears. The artificial tears with preservatives and even the artificial tears with “preservative free on contact” preservatives can actually cause dry eyes and slow healing. Preservative free artificial tears are produced in single use vials, and are more expensive than artificial tears with preservatives.

A nighttime lubrication gel, such as Refresh PM, can provide an environment friendly to healing while your wife sleeps. Depending upon the exact nature of the dry eyes, food supplements such as flax seed oil may be indicated. Details are in the article cited above.

Your wife's doctor would be able to measure the tear quantity and tear quality. These measurements will indicate what type of treatment is most appropriate. You're wife’s doctor can also diagnose the level of damage to the epithelium. This will indicate how aggressive the dry eye treatment needs to be.

If it is any consolation, PRK tends to induce less dry eye less often than Lasik.
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