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Dry Eyes After Lasik and All-Laser Lasik

Dry eye prevention techniques to use with Lasik, All-Laser Lasik, PRK, LASEK, and Epi-Lasik.


lasik
Lasik and All-Laser Lasik may induce dry eye symptoms during the normal six month healing period.

 

Dry Eyes after Lasik is a common condition during the immediate recovery period. If you have dry eyes before conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, or Epi-Lasik, you may not be excluded as a candidate for refractive surgery, but it is a condition that you must report to your doctor. Pre-existing dry eyes needs to be evaluated, treated, and resolved before surgery.

This article is about why dry eyes occur and how to prepare before surgery. A related article is  Lasik dry eye treatment.

Tear Quantity, Tear Quality

Two popular methods to test for dry eyes is a Tear Break-Up Test (TBUT) to determine tear quality and a Schirmer test to determine tear quantity. Dry eye treatment will depend upon the cause and severity of the dry eyes. Dry eyes is a medical condition and treatment would normally be covered under by major medical insurance plans.

Lasik Induced Temporary Dry Eyes

It is common to experience dry eyes for a short period after Lasik, All-Laser Lasik and sometimes PRK and its cousins LASEK and Epi-Lasik. Virtually everyone who has Lasik or All-Laser Lasik will experience dry eyes, but the important issue is to what degree and for how long.

For the vast majority of refractive surgery recipients, the degree of dry eye symptoms is not significant enough to cause difficulties. Even those who do have some trouble most often find the dry eye symptoms resolve within the normal six-month healing period. For an unfortunate few patients, Lasik induced dry eyes is a long-term complication that, although manageable, may be very disruptive.

There are many techniques to reduce the probability of dry eyes being induced by surgery, but most are the responsibility of the doctor. Prevention of Lasik related dry eyes is primarily focused on proper patient selection and treatment of pre-existing dry eye prior to surgery.

Drowning In Artificial Tears

There are many techniques to treat dry eye. The most common are preservative-free artificial tears, lubricating gel, punctal plugs, Restasis, and flax seed oil supplements. The technique best suited depends upon the exact nature of the tear deficiency and underlying cause. There are many types of artificial tear eye drops for slightly different purposes.

Less Dry Eye With Surface Ablation

Although PRK, LASEK, and Epi-Lasik may induce dry eye symptoms, Lasik and All-Laser Lasik seem to be the more commonly associated with dry eyes. This is partly because the Lasik techniques are more disruptive to the corneal nerves than PRK and LASEK. For this reason, patients with preexisting dry eyes may find PRK, LASEK, or Epi-Lasik a better choice. Other techniques such as CK, Intacs, RLE, and P-IOLs only marginally disrupt the corneal nerves, but have their own limitations. Whatever the surgery of choice, the less the corneal nerves are disrupted, the faster the nerves recover and normal tear function returns.

Be sure to discuss any dry eye problems (before or after surgery) with your doctor.

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.


Current Lasik Dry Eye Medical Journal News...

Static and dynamic rotational eye tracking during LASIK treatment of myopic astigmatism with the zyoptix laser platform and advanced control eye tracker.

Related Articles

Static and dynamic rotational eye tracking during LASIK treatment of myopic astigmatism with the zyoptix laser platform and advanced control eye tracker.

J Refract Surg. 2010 Jan;26(1):17-27

Authors: Neuhann IM, Lege BA, Bauer M, Hassel JM, Hilger A, Neuhann TF

PURPOSE:To evaluate the amount of cyclotorsion and the effect of static and dynamic rotational eye tracking with the Advanced Control Eye Tracker (Bausch & Lomb) based on iris recognition in the treatment of myopic astigmatism with LASIK. METHODS:All patients with myopic LASIK and attempted cylinder correction >0.75 diopters (D) on the Zyoptix 217z100 excimer laser platform between May 2005 and May 2007 were identified retrospectively through the existing databank. Pre- and postoperative refraction and the amount of cyclotorsion during treatment were extracted and analyzed in 828 eyes with >3-month follow-up. RESULTS:Preoperative mean manifest refraction spherical equivalent (MRSE) was -4.31+/-1.84 D (range: -0.37 to -9.50 D), and mean cylinder was -1.27+/-0.87 D (range: -0.75 to -6.75 D). Mean static rotation was 3.96+/-2.96 degrees (maximum 14.8 degrees ). Median dynamic rotation was 1.32+/-1.85 degrees (maximum 24 degrees ). At 3 months postoperatively, MRSE was -0.10+/-0.36 D (range: -2.25 to +1.25 D), and mean cylinder was -0.33+/-0.35 D (range: -2.00 to 0 D). Predictability was 90.2% within +/-0.50 D and 98.2% within +/-1.00 D (MRSE), and 82.5% within +/-0.50 D and 96.9% within +/-1.00 D (cylinder). The efficacy ratio was 0.99. Safety was 99.4% (5 dry eyes), reaching 100% at 12 months. Stability from 3 to 12 months (n=275) was 98.2% for sphere, 95.3% for cylinder, and 96.0% for MRSE. CONCLUSIONS:Our study demonstrates that significant cyclotorsion occurs before and during treatment. By using the dynamic rotational eye tracker presented, the efficacy of cylinder correction can be improved compared to those studies not performing cyclotorsional correction.

PMID: 20199008 [PubMed - in process]


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Last updated Thursday, February 25, 2010

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