Lasik and Dry Eye

Laser vision correction is no doubt a miracle of modern medicine. However, this wonderful innovation can sometimes create post-operative dry eye, a small but annoying price to pay for perfect vision.

It’s important to understand the symptoms of dry eye in order to alert your doctor of this condition before deciding which laser vision correction procedure you should have.

Dry Eye Syndrome is one of the most common eye problems that eye physicians encounter. Nearly 20% of all Americans suffer from dry eyes. Symptoms can include: tearing, redness, eye fatigue, itching, dryness, irritation and blurriness. LASIK can exacerbate dry eye if the condition pre-exists, it can also be created temporarily due to the procedure itself. Below I have outlined three different types of laser vision correction and their post-operative relationship to dry eye.

LASIK is a two step process. The first step involves creating the corneal flap. The second step is to reshape the cornea using a laser after which the flap is folded back into place. Before the advent of all -laser LASIK, the corneal flap was created using a hand held blade called a microkeratome. Some doctors still use this technique however, conventional bladed lasik not only has the highest occurrence of flap complications, it also causes the highest incidence of post-operative dry eye.

With advancements in LASIK, the corneal flap can now be created using a laser. All-laser LASIK such as IntraLase, creates the corneal flap by using a femtosecond laser. This laser creates tiny gas bubbles which coalesce to create the corneal flap. This method, while more precise and less complicated also has the potential side effect of dry eye but less so than with conventional bladed LASIK.

PRK and epi-lasik, were the very first types of laser vision correction performed before bladed LASIK became commonplace and are quickly regaining popularity. With PRK a flap is not created, instead the epithelial cells of the eye are removed using an alcohol based solution. While PRK may seem a bit archaic next to the new all laser LASIK technique available, post-operatively PRK and epi-lasik induce the least amount of dry eye compared to the other two above mentioned options.

The good news is that no matter which type of LASIK you choose, there is fast and easy in-office procedure that can help with dry eye called, punctal occlusion. Punctal plugs made of silicone or collagen can be inserted into the punctum of the eye to help increase the level of moisture and reduce dry eye symptoms. Temporary collagen plugs which dissolve over 7 to 10 days are first inserted to see how the eye reacts. If symptoms improve, then permanent silicone plugs are implanted.

This effortless procedure takes no more than 10 minutes in an ophthalmologist’s office. Most insurance companies will pay for punctal plugs, although it’s best to find out what co-pays and deductibles you might be responsible for. If you are considering LASIK and worried about post operative dry eye, ask your eye surgeon if he offers this simple solution. Your eyes will be glad you did.