Lasik Dry Eye

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Lasik dry eye, is a very uncomfortable experience. For those who have dry eyes, you know that this burning, “something in my eye” sensation gets worse before it gets better. Sometimes it leads to infection.

A connection was made between Lasik and dry eyes in the 1990s. In 1999 a survey of 550 Lasik patients was presented showing that between 40-50% experienced dry eye three months after surgery.

At a time when the incidence of complications was decreasing, the incidence of Lasik dry eye was increasing. Some of the contributing factors connecting Lasik and dry eyes included the patient having dry eye before the surgery, using steroids, after Lasik, hormonal changes in women of menopause age or women taking birth control.

Since then other Lasik-related causes of dry eyes have been attributed to contact lens wear before surgery and the surgery itself.

Many patients who couldn’t tolerate contact lenses sought Lasik as a solution. Lens intolerance is an indication of dry eye. Another concern was that contact lens disrupts corneal physiology.

Aside from conditions that patients had before surgery and medications, the surgery itself may contribute to Lasik and dry eyes. Studies show that some patients might experience a corneal sensation decrease after Lasik.

This situation involves a feedback loop. A feedback loop is a system involving a mechanism that senses a condition and sends that information to the brain. The brain, then, sends signals to that system to make an adjust.

Corneal sensation normally sends signals to the brain to let it know when it is getting dry. The brain then sends signals to the lacrimal glands telling them to produce tears.

During Lasik the corneal nerves are damaged when creating the flap and ablating the corneal tissue. After Lasik these nerves can’t sense dryness until they have healed. Healing can take several months.

Patients who had normal tearing before Lasik may experience Lasik dry eye afterwards. In the meantime your doctor may prescribe artificial tears. Medication is available to stimulate tear production.

Lacrisert is an insert that you place inside the lower lid. It is filled with lubricant that is released throughout the day. TheraTears is an electrolyte based artificial tear that replenishes the tear film over the eye. Another alternative is punctual plugs. These plugs are inserted into the tear ducts and help retain the existing tears in the eye. Treatment is temporary, and plugs that dissolve are available.

Some people’s tears have a chemical imbalance and evaporate quickly. Talk to your surgeon about this cause of dry eye.

Patients who have had dry eye before Lasik may be ineligible for Lasik because surgery may make their condition far worse. This is not always the case, so please discuss any dry eye experiences you’ve had with your eye surgeon.

Also, progress is continually being made both in laser eye surgery methods and follow-up care. Your eye surgeon will be able to update you on new developments.

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