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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

Comparison of visual and refractive outcomes following femtosecond laser- assisted lasik with smile in patients with myopia or myopic astigmatism.

J Refract Surg. 2014 Sep;30(9):590-6

Authors: Ganesh S, Gupta R

PURPOSE: To compare the visual and refractive out-comes of femtosecond laser-assisted LASIK with small-incision lenticule extraction (SMILE) in terms of visual acuity, contrast sensitivity, aberrations, and dry eye.
METHODS: A single-center prospective randomized study in which patients diagnosed as having myopia presenting for refractive correction were allocated to either a LASIK or SMILE group. The primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity, aberrations, and dry eye status. Patients were followed up at days 1 and 15 and 3 months; postoperative uncorrected visual acuity (UCVA), aberrations, dry eye, and contrast sensitivity were recorded and compared to preoperative data. Two postoperative subjective questionnaires were used to assess pain, pricking sensation, redness, glare, and overall patient satisfaction.
RESULTS: At day 1 postoperatively, 48 (96%) of 50 eyes in the SMILE group achieved a UCVA of 20/20 compared with 46 (92%) of 50 eyes in the LASIK group. At day 15 postoperatively, contrast sensitivity was similar in the two groups (P = .15), but by 3 months, it was better in the SMILE group than the LASIK group at all spatial frequencies (P < .0001). At 3 months postoperatively, 42 (84%) eyes in each group achieved a UCVA of 20/20, with 6 (12%) eyes in the SMILE group and 2 (4%) eyes in the LASIK group achieving 20/15. Higher-order aberrations at 3 months postoperatively were significantly higher in the LASIK group (0.437 + 0.103 pm) than in the SMILE group (0.267 + 0.07 pm; P < .001). Postoperative dry eye and glare were significantly more common following LASIK (P < .001).
CONCLUSIONS: Three-month results demonstrate that refractive accuracy, dry eye, contrast, and induced aberrations are better following SMILE rather than LASIK.

PMID: 25250415 [PubMed - in process]


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