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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

Refractive outcome of wavefront guided laser in situ keratomileusis and wavefront guided photorefractive keratectomy in high pre-existing higher order aberration.

Cont Lens Anterior Eye. 2014 Dec 30;

Authors: Arora R, Goel Y, Goyal JL, Goyal G, Garg A, Jain P

Abstract
PURPOSE: To compare visual outcome and higher order aberrations (HOA) between wavefront-guided LASIK (WF-LASIK) and wavefront guided PRK (WF-PRK) in patients with high preoperative HOA.
METHODS: Randomized prospective interventional study. Conducted at Guru Nanak Eye Centre, Maulana Azad Medical College, Delhi, India. Eighty myopic eyes of forty patients were included. Inclusion criteria: age more than 21 years, best corrected visual acuity of 20/20 or better, a stable refraction, to be off soft contact lens for minimum 14 days prior to preoperative examination, preoperative RMS HOA more than 0.35μ, preoperative central corneal thickness at least 500μm, estimated residual stromal bed thickness of at least 275μm in patients undergoing WF-LASIK and 350μm in patients undergoing WF-PRK. Exclusion criteria were severe dry eye, blepharitis, corneal disease and warpage, uveitis, posterior segment abnormalities involving the macula or optic nerve and systemic diseases. Patients were randomly divided into two groups. They underwent either WF-LASIK (group A) or WF-PRK (group B) over 2 years (40 eyes each). Patients were followed up for 6 months. Main outcome measures were efficacy, safety, stability, predictability and HOA.
RESULTS: At 6 months mean uncorrected visual acuity (logMAR) in group A was -0.01±0.04 and group B was 0.00±0.07 (P=0.23). HOA RMS (6mm pupil) in group A was 0.61±0.24μm and group B was 0.55±0.25μm. The increase was statistically significant in both the groups (P<0.05). Both the groups showed similar efficacy, predictability and safety.
CONCLUSION: WF-LASIK and WF-PRK have similar efficacy, safety and predictability, though WF-PRK induces less HOA.

PMID: 25555532 [PubMed - as supplied by publisher]

 


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