Laser-assisted in situ keratomileusis, commonly known as LASIK, is a surgical procedure performed to correct vision by reshaping the cornea with a laser. While the procedure is safe for many, it is not appropriate for everyone. Those undergoing LASIK may sometimes experience dry eye symptoms post-operatively.
LASIK is a technique designed to amend refractive errors in the eyes, enhancing their focusing abilities.
The processTrusted Source involves the precise use of a specialized laser to modify the curvature of the cornea, which is intended to improve the way light is focused onto the retina, potentially bettering vision overallTrusted Source.
LASIK, although effective in improving sight, may not be suitableTrusted Source for all individuals, particularly for those with pre-existing dry eye conditions. Additionally, dry eye syndrome can be a side-effect of undergoing LASIK surgery.
Dry eye disorder is characterized by discomfort due to inadequate tear lubrication within the eye. This occurs when the eye doesn’t produce an ample amount of tears, the tears are of inadequate quality, or there are issues with the tear film. Post-LASIK dry eye symptoms can range from:
mild dryness
feeling of irritation
experiencing pain or unease
eye tiredness
appearance of redness in the eye
Causes and risk factors for dry eye after LASIK
The onset of dry eye symptoms after LASIK surgery can be attributed to various factors.
The intricate process of LASIK surgery involves the creation of a flap in the cornea, which can disrupt certain nerves and diminish the eye’s sensitivity. Reduced corneal sensation might impede the eye’s feedback mechanism that prompts tear production, leading to insufficient lubrication and dry eye symptoms.
LASIK may also impact the eye’s form, potentially preventing even distribution of tears across the eye surface. Furthermore, the procedure might alter the level of mucin present in the eye, which is vital for maintaining tear stability.
Some studies suggest that dry eye symptoms post-LASIK might emerge due to a combination of insufficient lubrication and nerve damage incurred during the surgery. For certain individuals, the discomfort experienced after the procedure might be a manifestation of pain associated with this nerve injury.
Individuals with preexisting dry eye conditions prior to undergoing LASIK surgery are particularly at risk of developing postoperative dry eye symptoms.
Research indicates that females are notably more inclined to experience postoperative dry eye symptoms. A study from 2017 points out that the risk escalates with age, notably past 50 years old.
The specific refractive error or the shape of an individual’s eye may also play a role, with those possessing either low or high refractive errors more susceptible to dry eye after surgery.
Additional factors that could heighten the risk of postoperative difficulties include:
- Keratoconus, which causes the cornea to thin
- Eye infections
- Glaucoma disorders
- Cataract conditions
Certain systemic conditions like Sjogren’s syndrome and diabetes, which can compromise tear production and impede post-surgery recovery, may further increase the likelihood of complications.
For people with these ailments, particularly when symptoms are inadequately managed, the chance of experiencing post-LASIK complications is greater, possibly making them less ideal candidates for the procedure.
Post-LASIK Dry Eye Recovery Time
Dry eye symptoms are frequently reported by patients following LASIK surgery. Typically, these symptoms subside a few months post-operation. Nonetheless, research indicates that a proportion of individuals, ranging from 10% to 40%, may continue to experience some degree of dry eye symptoms six months after the procedure. While it is uncommon, there are cases where dry eye symptoms persist for more than a year post-surgery.
Treatment and prevention
Post-LASIK dry eye often resolves within several months, but individuals with chronic dry eye might require longer-term management strategies. To address dry eye complications, treatment typically involves moisture supplementation, tear production stimulation, and inflammation control. Common treatment modalities include:
Lubricating eye drops: Serving as the primary treatment, these drops aid in moistening the corneal surface. Available without a prescription, these artificial tears can provide immediate relief.
Anti-inflammatory medications: Since dry eye can develop from inflammatory processes which may affect tear secretion, ophthalmologists may prescribe anti-inflammatory eye drops like cyclosporine (Restasis) or lifitegrast (Xiidra) to minimize inflammation.
Tear duct plugs: Small, either silicone or soft material, plugs may be inserted into the tear ducts to slow the drainage of tears, thereby keeping the eyes more hydrated.
Blood-derived eye drops: Custom-made for each patient, these eye drops are made from the patient’s own blood to closely mimic the composition of their natural tears.
Preventative Actions for Dry Eye After LASIK
To minimize the likelihood of experiencing dry eye after the surgery, patients should thoroughly adhere to their eye doctor’s prescribed medications and recovery guidelines. Additional preventative measures to reduce the onset of dry eye symptoms include:
- Avoidance of dry, arid conditions and using humidifiers to add moisture to the environment.
- Staying well-hydrated by drinking ample amounts of water.
- Ensuring adequate rest and proper sleep habits.
- Utilizing wraparound sunglasses in outdoor settings to shield the eyes from potential irritants.
Intake of essential fatty acids, particularly omega-3s, has also been indicated in some studies to alleviate symptoms of dry eye in certain individuals. These can be incorporated into the diet through foods like salmon and tuna or via dietary supplements.
Can a person get LASIK if they have dry eye?
An ophthalmologist will carry out a thorough eye evaluation to ascertain if an individual is an appropriate candidate for LASIK. Part of this assessment includes detecting any indicators of dry eye by assessing the tear production and quality on the individual’s eye.
Individuals with dry eye may still qualify for LASIK. Yet, eye care professionals might recommend managing and treating the existing dry eye condition first, as the procedure could potentially exacerbate the symptoms.
Should an individual be unable to adequately control symptoms of dry eye prior to the procedure, their ophthalmologist might suggest opting out of LASIK surgery.
Alternative options
While LASIK is a prevalent choice for vision correction, there are other refractive procedures available to improve visual acuity.
Small incision lenticule extraction (SMILE) resembles LASIK in its approach to reshaping the cornea through a minor cut. Some studies suggest that SMILE might pose a reduced risk of postoperative dry eye compared to LASIK, given its minimal corneal involvement.
Conductive keratoplasty uses radiofrequency energy to alter corneal curvature. It’s less invasive but may not be appropriate for all candidates, and the effects may be temporary.
Another option is the surgical insertion of a phakic contact lens, also known as a phakic intraocular lens (PIOL) or implantable contact lens (ICL). This method doesn’t involve altering the cornea, potentially resulting in a lesser incidence of dry eye. Nevertheless, instances of dry eye post-ICL implantation have been observed.
These surgical procedures are not universally applicable, each carrying specific prerequisites. Eye care professionals will evaluate an individual’s ocular and medical backgrounds to guide them towards the most suitable vision correction method.
For those seeking non-invasive choices, prescription eyeglasses or single-use contact lenses remain viable alternatives for vision correction.
When to contact a doctor
Postoperative dry eye is a frequent occurrence but typically dissipates over a span of several months. Compliance with the ophthalmologist’s recovery regimen and regular postoperative check-ups are crucial. Should an individual encounter an exacerbation of symptoms or sustain discomfort and other related symptoms for an extended period after surgery, they should consult their doctor.
Summary
LASIK is a widely accepted, predominantly safe intervention offering enduring benefits for numerous patients. Nevertheless, post-surgical dry eye symptoms are a prevalent experience. While these symptoms often subside naturally, a variety of treatments are accessible for their management.
Individuals with existing dry eye issues may be deemed unsuitable for LASIK and might need to explore alternative correction measures. Contrarily, if individuals can effectively regulate their dry eye symptoms, their eye care provider might greenlight LASIK surgery.
