Stop LASIK dry eye Pain? Get help today

Dry eye is common after LASIK vision correction surgery. Half the people who undergo LASIK have some degree of dry eyes after the procedure. The dry eye symptoms can persist for weeks, months, or even longer.

But to keep the problem in perspective, many people who seek LASIK already have dry eyes. Contact lens wearers who find their lenses uncomfortable because of dry eyes may investigate LASIK as an alternative because they do not want to wear eyeglasses.

Screening for LASIK has led to advances in dry eye detection and treatment. People wanting laser vision correction can solve their pre-existing dry eye problem before LASIK surgery.

Why LASIK Cause Dry Eyes?

LASIK causes some nerves in the cornea to be cut, which reduces corneal sensitivity. Your eye may not sense the need for lubrication, causing your body to produce fewer tears, leading to dry eye syndrome.

Dry eyes after LASIK can cause both discomfort and vision abnormalities. For this reason, many eye surgeons now recommend that you use lubricating eye drops or other therapies to help maintain eye moisture.

As a precaution, you also may be given treatments to increase eye lubrication in advance of a LASIK procedure, even if you don’t have any sign of dry eyes.

PRK can be an alternative to LASIK when dry eyes are severe.

Screening for Dry Eyes before LASIK 

Both the quality and the quantity of your tears produce are factors in the development of dry eyes, affecting healing after eye surgery.

Eye doctors now recognize that the best LASIK outcomes depend on controlling dry eyes. You will undergo screening in advance of a procedure.

Tests for detecting dry eyes include:

• Schirmer test. The eye doctor places a thin strip of paper under the lower eyelid to measure tear production.
• Tear breakup time – is where a small amount of dye is placed on the eye’s surface to monitor how tears distribute and when they “break up” on the eye’s surface. It measures the viscosity of the tears. 
• Imaging. Keratometers or other instruments that provide a view of the tear film without touching the eye’s surface.
• MMP-9 Testing – will collect a small sample of your tears from the inside of your bottom lid will be collected. Within minutes, high levels of this protein mean you will have problems with inflammatory dry eye after LASIK.

Your assessment as a possible candidate for a LASIK procedure will include determining if you have an underlying condition that might be causing dry eyes.

Who Is Most at Risk of Dry Eyes After LASIK?

People with high degrees of myopia have a greater risk of dry eyes after LASIK than people with lesser degrees of nearsightedness before LASIK surgery.

• Older age, mainly if you are female and have undergone menopause.
• Allergy medications (antihistamines), certain blood pressure medications, and anti-depressants can decrease eye moisture.
• Autoimmune diseases such as Sjogren’s syndrome.
• Arid climates or environments, such as a room that is highly heated or air-conditioned.

Again, having dry eyes before a LASIK procedure will not automatically eliminate you as a candidate. But your eye doctor will need to consider the severity of your condition and the possibility of effective treatment before recommending a LASIK.

Dry Eye Treatment Before and After LASIK

Even if you have a pre-existing dry eye condition, the eye doctor may consider treating you before LASIK without eliminating you as a candidate.

Your eye doctor may also treat you for dry eyes before a LASIK procedure as a precaution, even if your tear production ordinarily is normal.

Your eye doctor may advise you to take flaxseed oil or fish oil orally before your vision correction surgery improves your tear film. You also may need to use lubricating eye drops before and after a LASIK procedure.

LASIK can cause dry eyes. TheraLife can help

 An oral dry eye treatment from TheraLife is also an excellent option for before and after LASIK.  The oral treatment provides long-lasting, sustainable relief all day long—no more drops. 

Your eye surgeon also might recommend prescription eye drops such as Restasis or Xiidra to reduce inflammation and help your body formulate more tears.

Other common dry eye remedies include:

• punctal plugs– which block tear drainage channels to increase moisture on the eye, 
• anti-inflammatory medications – such as corticosteroids administered as eye drops.

Dry Eye Treatments after LASIK 

When you consult with your LASIK surgeon for your assessment as a candidate, make sure you mention any eye symptoms that could indicate a dry eye problem. These dry eye symptoms could include a foreign body sensation or eye irritation. Even watery eyes can mean that you have dry eyes.

Eating taking omega-3 fish oil and eating food containing these “good fats,” such as salmon, can help maintain a healthy tear film. Drinking plenty of water also can help keep your body and your eyes adequately hydrated.

Also, make sure you have a frank discussion with your LASIK surgeon about the possibility of developing dry eyes following a procedure. Inquire about specific steps that can take for dry eyes to restore the eye’s tear film and comfort until healing is complete.

Many dry eye symptoms after a refractive LASIK surgery procedure are usually relatively mild and disappear in time. However, some LASIK patients have reported severe and ongoing problems with dry eyes.

References

1. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop. Ocul Surf. 2007;5(2):75–92.
2. Sutton GL, Kim P. Laser in situ keratomileusis in 2010 – a review. Clin Experiment Ophthalmol. 2010;38(2):192–210.
3. Yu EY, Leung A, Rao S, Lam DS. Effect of laser in situ keratomileusis on tear stability. Ophthalmology. 2000;107(12):2131–2135
4. McGhee CN, Orr D, Kidd B, Stark C, Bryce IG, Anastas CN. Psychological aspects of excimer laser surgery for myopia: reasons for seeking treatment and patient satisfaction. Br J Ophthalmol. 1996;80(10):874–879.
5. De Paiva C, Chen Z, Koch D, et al. The incidence and risk factors for developing dry eye after myopic LASIK. Am J Ophthalmol. 2006;141(3):438–445.
6. Melki SA, Azar DT. LASIK complications: etiology, management, and prevention. Surv Ophthalmol. 2001;46(2):95–116.
7. Hovanesian JA, Shah SS, Maloney RK. Symptoms of dry eye and recurrent erosion syndrome after refractive surgery. J Cataract Refract Surg. 2001;27(4):577–584.
8. Battat L, Macri A, Dursun D, Pflugfelder SC. Effects of laser in situ keratomileusis on tear production, clearance, and the ocular surface. Ophthalmology. 2001;108(7):1230–1235.
9. Toda I, Asano-Kato N, Komai-Hori Y, Tsubota K. Dry eye after laser in situ keratomileusis. Am J Ophthalmol. 2001;132(1):1–7. [
10. Solomon KD, Holzer MP, Sandoval HP, et al. Refractive Surgery Survey 2001. J Cataract Refract Surg. 2002;28(2):346–355. [
11. Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W. Utility assessment among patients with dry eye disease. Ophthalmology. 2003;110(7):1412–1419.
12. Buchholz P, Steeds CS, Stern LS, et al. Utility assessment to measure the impact of dry eye disease. Ocul Surf. 2006;4(3):155–161.
13. Brown MM, Brown GC, Brown HC, Peet J, Roth Z. Value-based medicine, comparative effectiveness, and cost–effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome. Arch Ophthalmol. 2009;127(2):146–152.
14. Levinson BA, Rapuano CJ, Cohen EJ, Hammersmith KM, Ayres BD, Laibson PR. Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: reasons for patient dissatisfaction. J Cataract Refract Surg. 2008;34(1):32–39.
15. Jabbur NS, Sakatani K, O’Brien TP. Survey of complications and recommendations for management in dissatisfied patients seeking a consultation after refractive surgery. J Cataract Refract Surg. 2004;30(9):1867–1874.
16. Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea. 1998;17(6):584–589.
17. Shin SY, Lee YJ. Conjunctival changes induced by LASIK suction ring in a rabbit model. Ophthalmic Res. 2006;38(6):343–349.
18. Rodriguez AE, Rodriguez-Prats JL, Hamdi IM, Galal A, Awadalla M, Alio JL. Comparison of goblet cell density after femtosecond laser and mechanical microkeratome in LASIK. Invest Ophthalmol Vis Sci. 2007;48(6):2570–2575. [PubMed] [Google Scholar]
19. Rodriguez-Prats JL, Hamdi IM, Rodriguez AE, Galal A, Alio JL. Effect of suction ring application during LASIK on goblet cell density. J Refract Surg. 2007;23(6):559–562. [
20. Konomi K, Chen LL, Tarko RS, et al. Preoperative characteristics and a potential mechanism of chronic dry eye after LASIK. Invest Ophthalmol Vis Sci. 2008;49(1):168–174.
21. Solomon R, Donnenfeld ED, Perry HD. The effects of LASIK on the ocular surface. Ocul Surf. 2004;2(1):34–44.
22. Lee JB, Ryu CH, Kim J, Kim EK, Kim HB. Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg. 2000;26(9):1326–1331.
23. Vongthongsri A, Chuck RS, Pepose JS. Corneal iron deposits after laser in situ keratomileusis. Am J Ophthalmol. 1999;127(1):85–86.
24. Sullivan BD, Whitmer D, Nichols KK, et al. An objective approach to dry eye disease severity. Invest Ophthalmol Vis Sci. 2010;51(12):6125–6130.
25. Suzuki M, Massingale ML, Ye F, et al. Tear osmolarity as a biomarker for dry eye disease severity. Invest Ophthalmol Vis Sci. 2010;51(9):4557–4561.
26. Albietz JM, McLennan SG, Lenton LM. Ocular surface management of photorefractive keratectomy and laser in situ keratomileusis. J Refract Surg. 2003;19(6):636–644.
27. Pflugfelder SC, Maskin SL, Anderson B, et al. A randomized, double-masked, placebo-controlled, multicenter comparison of loteprednol etabonate ophthalmic suspension, 0.5%, and placebo for treatment of keratoconjunctivitis sicca in patients with delayed tear clearance. Am J Ophthalmol. 2004;138(3):444–457.
28. Toda I, Asano-Kato N, Hori-Komai Y, Tsubota K. Laser-assisted in situ keratomileusis for patients with dry eye. Arch Ophthalmol. 2002;120(8):1024–1028.
29. Toda I, Kato-Asano N, Hori-Komai Y, Tsubota K. Dry eye after LASIK enhancement by flap lifting. J Refract Surg. 2006;22(4):358–362.
30. Albietz J, Lenton L, McLennan S. The effect of tear film and ocular surface management on myopic LASIK outcomes. Adv Exp Med Biol. 2002;506(Pt A):711–717.
31. Shoja MR, Besharati MR. Dry eye after LASIK for myopia: incidence and risk factors. Eur J Ophthalmol. 2007;17(1):1–6.
32. Albietz JM, Lenton LM, McLennan SG. Effect of laser in situ keratomileusis for hyperopia on tear film and ocular surface. J Refract Surg. 2002;18(2):113–123.
33. Albietz JM, Lenton LM, McLennan SG. Dry eye after LASIK: comparison of outcomes for Asian and Caucasian eyes. Clin Exp Optom. 2005;88(2):89–96.
34. Benitez-del-Castillo JM, del Rio T, Iradier T, Hernandez JL, Castillo A, Garcia-Sanchez J. Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea. 2001;20(1):30–32.
35. Gimbel HV, Basti S, Kaye GB, Ferensowicz M. Experience during the learning curve of laser in situ keratomileusis. J Cataract Refract Surg. 1996;22(5):542–550.
36. Fraunfelder FW, Rich LF. Laser-assisted in situ keratomileusis complications in diabetes mellitus. Cornea. 2002;21(3):246–248.
37. Nejima R, Miyata K, Tanabe T, et al. Corneal barrier function, tear film stability, and corneal sensation after photorefractive keratectomy and laser in situ keratomileusis. Am J Ophthalmol. 2005;139(1):64–71.
38. Patel S, Alio JL, Artola A, Martinez MJ. Tear volume and stability after LASIK. J Refract Surg. 2007;23(3):290–298.
39. Wilson SE, Ambrsio R. Laser in situ keratomileusis-induced neurotrophic epitheliopathy. Am J Ophthalmol. 2001;132(3):405–406.
40. Wilson S. Laser in situ keratomileusis-induced (presumed) neurotrophic epitheliopathy. Ophthalmology. 2001;108(6):1082–1087.
41. He J, Bazan NG, Bazan HE. Mapping the entire human corneal nerve architecture. Exp Eye Res. 2010;91(4):513–523.
42. Ambrosio R, Tervo T, Wilson S. LASIK-associated dry eye and neurotrophic epitheliopathy: pathophysiology and strategies for prevention and treatment. J Refract Surg. 2008;24(4):396–407.
43. Lee HK, Lee KS, Kim HC, Lee SH, Kim EK. Nerve growth factor concentration and implications in photorefractive keratectomy vs laser in situ keratomileusis. Am J Ophthalmol. 2005;139(6):965–971.
44. Savini G, Barboni P, Zanini M, Tseng SC. Ocular surface changes in laser in situ keratomileusis-induced neurotrophic epitheliopathy. J Refract Surg. 2004;20(6):803–809.
45. Patel S, Perez-Santonja JJ, Alio JL, Murphy PJ. Corneal sensitivity and some properties of the tear film after laser in situ keratomileusis. J Refract Surg. 2001;17(1):17–24.
46. Michaeli A, Slomovic AR, Sakhichand K, Rootman DS. Effect of laser in situ keratomileusis on tear secretion and corneal sensitivity. J Refract Surg. 2004;20(4):379–383.
47. Kohlhaas M. Corneal sensation after cataract and refractive surgery. J Cataract Refract Surg. 1998;24(10):1399–1409.
48. Kim WS, Kim JS. Change in corneal sensitivity following laser in situ keratomileusis. J Cataract Refract Surg. 1999;25(3):368–373.
49. Nassaralla BA, McLeod SD, Nassaralla JJ., Jr Effect of myopic LASIK on human corneal sensitivity. Ophthalmology. 2003;110(3):497–502.
50. Linna TU, Vesaluoma MH, Perez-Santonja JJ, Petroll WM, Alio JL, Tervo TM. Effect of myopic LASIK on corneal sensitivity and morphology of subbasal nerves. Invest Ophthalmol Vis Sci. 2000;41(2):393–397.