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Dry Eyes After Lasik and Bladeless Lasik

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


Image of woman standing in a windy desert.  
Lasik and Bladeless 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, Bladeless 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, Bladeless Lasik and sometimes PRK and its cousins LASEK and Epi-Lasik. Virtually everyone who has Lasik or Bladeless 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 Bladeless 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 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.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.


Recent Lasik & Dry Eyes Medical Journal Articles...

Related Articles

Corneal Neuralgia after LASIK.

Optom Vis Sci. 2015 Jul 3;

Authors: Theophanous C, Jacobs DS, Hamrah P

Abstract
PURPOSE: To illustrate that corneal neuralgia may be the basis for refractory dry eye syndrome after laser-assisted in situ keratomileusis (LASIK).
METHODS: The methodology used is that of a retrospective medical record review of a small case series.
RESULTS: Three male patients, aged 30 to 48 years, referred in 2012 for dry eye syndrome refractory to treatment within 1 year of LASIK or LASIK enhancement are reported. Each patient gave history of eye pain, light sensitivity, and difficulty with visual activities beginning within 2 months of LASIK or LASIK enhancement. Best-corrected visual acuity was 20/15 or 20/20 in each of the six eyes. Tear-centered models and metrics did not explain persistent symptoms, which was consistent with inadequate response to standard dry eye treatments used before referral and reported here. In vivo confocal microscopy was abnormal at presentation in each case and was followed over time. Treatments undertaken subsequent to referral included autologous serum tears (three cases), PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) treatment (two cases), and systemic agents for pain, anxiety, or depression (three cases). By the end of 2013, at a mean of 23 months after LASIK or LASIK enhancement, symptoms improved in all three patients.
CONCLUSIONS: Patients with persistent dry eye symptoms out of proportion to clinical signs after LASIK have a syndrome that may best be classified as corneal neuralgia. In vivo confocal microscopy can be informative as to the neuropathic basis of this condition. In keeping with current understanding of complex regional pain syndrome, early multimodal treatment directed toward reducing peripheral nociceptive signaling is warranted to avoid subsequent centralization and persistence of pain. Distinguishing this syndrome from typical post-LASIK dry eye remains a challenge.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

PMID: 26154691 [PubMed - as supplied by publisher]

 


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