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Artificial Tear Eye Drops After Lasik
The selection of artificial tear eye drops required after Lasik,
All-Laser Lasik, PRK, LASEK, or Epi-Lasik s very important.
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Preservative free artificial tears are always packaged in
individual use vials. Anything in a bottle has some sort
of preservative.
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Every artificial tear manufacturer has a slightly different
formula for each brand. Some eye drops are thick to provide more
protection, others are thin to provide rapid relief without vision
disruption, however all can be divided into one of three categories:
preserved, preservative free, preservative free on contact.
The preservatives used in artificial tears are a mild toxin.
A purpose of a toxin in an artificial tear is to kill anything that
may promote spoilage of the eye drops and to keep the eye drops
aseptic.
The eye does not like toxins too much, even low level toxins.
Toxins in eye drops can cause irritation, redness, even inflammation.
An eye healing from conventional or custom
wavefront
Lasik,
All-Laser Lasik,
PRK,
LASEK,
Epi-Lasik,
NearVision CK,
RLE, or any
refractive surgery procedure, needs all the help it can get
and applying a toxin is not helpful. Even if the eye drops do not
cause irritation and feel fine, the toxins may be slowing or negatively
affecting the healing process.
Newer "preservative free on contact" artificial tears have an
advantage that the toxin quickly dissipates, but the speed at which
the toxin dissipates varies greatly. As an example, one such drop
dissipates the preservative by exposure to ambient light. If you
put in the drops, close your eyes, and go to bed with the lights
out, that preservative is not going to dissipate very quickly. Artificial
tears that claim to be preservative free on contact are not necessarily
appropriate immediately after surgery.
It is always best to use true preservative free eye drops during
the immediate recovery period after Lasik or similar laser eye surgery.
It is even a good idea to use preservative free eye drops long after
surgery, but they are more expensive and after the cornea has healed
adequately an artificial tear with a preservative or is preservative
free on contact may be appropriate. Check with your doctor.
If eye irritation is experiences with the use of a preservative
free artificial tear, it may be the formulation is incompatible.
It is possible that something in a particular formula of a particular
brand is causing irritation, with or without a preservative. You
would need to try different brands to see what works best for you.
Listed below are several of the major artificial tears categorized
by active ingredients.
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Artificial Tear Eye Drops
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Hydroxypropyl Methylellulose (HPMC)
Artificial Tears |
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Bion Tears |
0.3% HPMC, 0.1% Dextran 70. (bicarbonate
& zinc help mucus & surface cells),
Preservative-free.
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Tears Naturale Forte |
0.3% HPMC, 0.1% Dextran 70, 0.2%
Glycerin
Polyquad 0.001% as preservative.
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Tears Natural II Polyquad |
0.3% HPMC, 0.1% Dextran 70, Polyquad
0.001% as preservative.
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Tears Natural Free |
0.3% HPMC, 0.1% Dextran 70, Preservative-free.
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GenTeal Mild |
Active ingredient: HPMC, 0.2%
Inactive ingredients: Boric acid,
calcium chloride dihydrate, sodium
perborate, phosphonic acid, potassium
chloride, purified water, and sodium
chloride.
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GenTeal Moderate |
Active ingredient: HPMC, 0.3% Inactive
ingredients: Boric acid, sodium
perborate, phosphonic acid, potassium
chloride, purified water, and sodium
chloride. |
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GenTeal
Severe |
Active ingredient: HPMC, 0.3%
Inactive ingredients: Boric acid,
calcium chloride, magnesium chloride,
potassium chloride, purified water,
sodium borate, sodium chloride,
and zinc sulfate.
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Visine tears |
0.2% HPMC, 0.2% Glycerin, 1%
Polyethylene Glycol 400, Benzalkonium
Chloride (0.01%) as preservative.
Visine is also available as Preservative
Free single-use vials
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Carboxyl Methylcellulose (CMC) Artificial
Tears |
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Refresh Tears |
0.5% CMC, Purite as preservative.
Refresh Plus Tears also has
0.5% CMC, but is preservative free
& comes in single use vials.
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Refresh Liquigel |
1% CMC, Purite as preservative.
Refresh Celluvisc also has 1%
CMC, but is preservative free &
comes in single use vials.
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Thera Tears |
0.25% CMC, Hypotonic, Preservative-free.
Single-use container pack.
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Polyvinyl Alcohol (PVA) Artificial
Tears |
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Murine Tears |
0.5% Polyvinyl Alcohol , 0.6%
Povidone. (has Bicarbonate), Benzalkonium
Chloride (0.01%) as preservative.
Manufactured by Ross (Abbott Labs)
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HypoTears |
1% Polyvinyl Alcohol , 1% Polyethylene
Glycol 400. Hypotonic, Benzalkonium
Chloride (0.01%) as preservative.
Hypotears is also available as Preservative
free single-use vials
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Akwa Tears |
1.4% Polyvinyl Alcohol. Hypotonic,
Benzalkonium Chloride (0.005%) as
preservative.
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MiniDrops Eye Therapy |
Active Ingredients (in each ml):
Polyvinylpyrrolidone (6 mg), Polyvinyl
Alcohol (14 mg). Inactive Ingredient:
Sodium Chloride. Preservative free
single-use vials |
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Tears Again |
1.4% Polyvinyl Alcohol.
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Glycerine Artificial Tears & Others |
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Systane |
Polyethylene Glycol 400 0.4%
(lubricant), Propylene Glycol 0.3%
(lubricant), Hydroxypropyl Guar
(Gel forming Matrix), Polyquaternium-1
as preservative.
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Advanced Eye Relief |
1% Propylene Glycol, 0.3% Glycerin
Benzalkonium Chloride (0.01%) as
preservative.
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Similasan homeopathic |
Belladonna HPUS 6X alkaloids,
Euphrasia, Mercurius sublimatus.
Sodium silver chloride complex 0.001%
as preservative.
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Tetrahydrozoline HCl Artifical Tears |
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Visine AC |
Active Ingredients: Tetrahydrozoline
HCl 0.05%, Zinc sulfate 0.25%
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Oil Containing Eye Drops - Prevent
Evaporation of Tears |
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Refresh Endura |
Castor oil, polysorbate-80, Carbomer
1342 & Glycerin, Preservative Free.
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Soothe Emollient Eye Drops |
Light mineral oil 1.0%, Mineral
oil 4.5% (Restoryl), polysorbate-80,
Polyhexamethylene biguanide as preservative.
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Contact Lens Rewetting Drops (can
be used while wearing soft or hard/gas
permeable contact lens) |
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Clerz Plus |
Tetronic 1304 helps lens retain
moisture & shields from protein
build up. RLM-100 removes lens deposits.
Polyquad® is the preservative.
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Aquify Comfort Drops |
Sodium Hyaluronate 0.1%, Sodium
Perborate is the preservative.
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Complete Blink-N-Clean Lens Drops |
Hydroxypropyl methylcellulose
is the lubricant, tyloxapol is the
surfactant. Polyhexamethylene biguanide
is the preservative.
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Opti-Free Express Rewetting drops
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Sterile, buffered, isotonic,
aqueous solution. No hydrogel lubricants.
Polyquad is the preservative.
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Moisture Plus Rewetting Drops |
Sterile, buffered, isotonic,
aqueous solution. No hydrogel lubricants.
Preservative-free.
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ReNu Rewetting drops |
Poloxamine removes dirt & protein
deposits. Sorbic Acid is the preservative.
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Eye Ointments & Gels |
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Refresh PM ointment |
57.3% White Petrolatum, 42.5%
Mineral Oil
Preservative Free.
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Tears Naturale PM |
56.8% White Petrolatum, 42.5%
Mineral Oil
Preservative Free.
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Genteal Gel |
0.3% Hydroxypropyl Methylcellulose,
Carbopol 980
GenAqua (Sodium Perborate) as preservative.
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Tears Again NIGHT & DAY Gel |
1.5% Carboxy Methylcellulose,
Dissipate (stabilized oxyborate
complex) as a preservative.
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If you are ready to choose a doctor to be evaluated for conventional
or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik,
NearVision CK, RLE, or any
refractive surgery procedure, we highly recommend you consider
a doctor who has been evaluated and certified by the USAEyes
nonprofit organization. Locate a USAEyes Evaluated & Certified
Lasik Laser Eye Surgery Doctor.
If this article did not fully answer your questions, use our
free
Ask Lasik Expert patient forum.
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Current Artificial Tears Medical Journal News...
Plugs for occlusion of the lacrimal drainage system.
Plugs for occlusion of the lacrimal drainage system.
Dev Ophthalmol. 2008;41:193-212
Authors: Tost FH, Geerling G
Background: Next to medical therapy, blockage of the lacrimal drainage system is the commonest form of treating dry eye. Rather than applying an artificial tear, the latter helps to preserve any remaining natural tear fluid, which by far has the best wetting and nutrient capacity for the ocular surface. A temporary block is usually induced by implants to tamponade on the level of the lacrimal puncta or canaliculi. Materials and Methods: A Medline search was performed with the keywords 'lacrimal drainage system, punctum, canaliculus, temporary occlusion, plug, dry eye, keratoconjunctivitis sicca' for the years 1986-2006. Plugs are a suitable treatment in patients with moderate or more severe disease. The characteristics of the devices used and procedures as well as the complications described were analyzed. Results: Criteria such as a lack of Schirmer strip wetting, ocular surface staining and the frequency of artificial tears instillation should be assessed prior to making the decision to occlude the lacrimal drainage. Lacrimal plugs made of silicone or a thermodynamic acrylic polymer, such as hydrogel, appear to be safe and effective, although each patient should be followed on a long-term basis to exclude alterations of the lacrimal system such as chronic inflammatory reactions, extrusion or migration, which may all lead to discomfort. High-frequency ultrasound as a non-invasive, simple diagnostic technique can be used to identify the type or position of plug or inflammatory reaction present. Conclusion: Tamponade of the lacrimal drainage system is a simple procedure that is underused. Preserving natural tears by blocking the lacrimal drainage system can successfully maintain the integrity of the ocular surface and corneal transparency and visual acuity. In patients with moderate or severe dry eye, it is capable of improving quality of life and preventing loss of vision.
PMID: 18453770 [PubMed - in process]
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Artificial Tears
Last updated
Wednesday, July 02, 2008
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