Dry eyes after LASIK FAQ
Please select your question from the following list of FAQs:
What is the cause of dry eyes after LASIK and PRK?
LASIK and PRK are known to decrease the normal amount of lubrication of the eye. The corneal nerves supply information to the lacrimal gland to supply a continual amount of lubrication. With LASIK and PRK, the corneal nerves are severed and no longer supply the appropriate information, leading to dry eyes. Over the course of weeks to months to years, the nerves heal, and the lubrication level of the eye can return to normal. However some patients with pre-existing dry eyes are at risk for prolonged dry eyes that can cause significant symptoms, and some patients even years after surgery have dryer eyes than before surgery. Dr. Eric Donnenfeld has presented research that shows that LASIK flaps with a superior hinge lead to more dry eye symptoms that LASIK with a nasal hinge. As well, there are some studies to suggest that surface laser (LASEK/PRK) causes less dry eye than LASIK, since fewer corneal nerves are damaged with surface laser.
What are the possible treatments for dry eyes?
In general, the use of artificial tears is important following LASIK and PRK. Careful discussion with one’s surgeon both before and after surgery are important in determining the amount of lubrication required. In severe dry eye cases, a punctal plug can be used. A punctal plug is a plastic plug that prevents the outflow of tears from your eye to the nose. This devise can raise the amount of lubrication in the eye, just like plugging the drain of a sink. The plastic plugs can be placed and removed months later if required.
List of possible treatments for dry eye beyond lubricating drops
1. Genteal gel (or another lubricating gel): tends to last longer than lubricating drops, but of course can sometimes blur vision
2. Punctal plugs. These fit into the drainage ducts of one's tears, and help retain both one's own tears and any lubricating drops. Generally lower punctal plugs are placed intitially, and if necessary, upper plugs are placed.
3. Moisture chamber: sleeping with moisture chambers will help retain the moisture in one's eyes at night time.
4. Topical steroid eye drops. Since there is often an inflammatory component to dry eyes, steroid eye drops can be helpful 5. Cyclosporine eye drops: this very powerful anti-inflammaotry medication is also being looked into, but does have risks. Its effects with dry eyes and LASIK are still being examined.
6. Flax seed oil: herbal remedy that some dry eye patients reports can be helpful. It is important to watch one's cholesterol levels and lipid levels. This has not yet been proven to help dry eyes, so please talk with your doctor before using this.
7. Science-based health has a new supplement called hydroeyes which may be helpful. Currently 3 studies are underway to see if this supplement will be of help.
8. Saligen : This medication is used for Sjogren's syndrome, and can increase one's secretions of tears. This medication does lead to increased production of saliva and has side effects which one must discuss with their doctor.
9. There is a new medication called Evoxac (cevimeline) which is also used for dry mouth and dry eyes. This medication also has some side effects, although less side effects than saligen, so please talk with your doctor.
10. Doxycycline: This antibiotic can help patients with oil gland problems. The oil component of tears is critical, so if there is a problem with the oils, doxycycline at times can be very helpful,
11. Barrier effect: Since air conditioning, wind and fans can exacerbate dry eyes, many patients report success wearing glasses to protect their eyes.
Please talk with your own doctor about all of these treatments prior to using them.
Updated July 2002