Are refractive surgeons aware of this study? It demonstrates by confocal microscopy that LASIK patients, on average, lose >40% of their corneal nerve density at the 3 year point.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retri...=15505047&query_hl=2

Invest Ophthalmol Vis Sci. 2004 Nov;45(11):3991-6.
Corneal reinnervation after LASIK: prospective 3-year longitudinal study.
Calvillo MP, McLaren JW, Hodge DO, Bourne WM.
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

This is frightening. Credible researchers from a top-notch institution have gathered subjective measurements of nerve damage in patients who have had LASIK. How can any surgeon continue to perform this surgery without including this information in his/her informed consent? And what patient would knowlingly consent to such surgery?

Are refractive surgeons considering the consequences of such substantial nerve loss with aging? What will happpen to millions of post-LASIKs when their eyes dry naturally with age?

I also find it disturbing that the former head of the ASCRS had this to say about LASIK-induced corneal nerve damage in FDA hearings in 2001, but this information was witheld from the public:

From the FDA transcripts:
Dr. I Howard Fine, Past President of the American Society of Cataract and Refractive Surgery:

"As we all know, Lasik transects the cornea nerves, therefore inducing dry eyes in most patients."
http://www.fda.gov/ohrms/dockets/ac/01/transcripts/3806t1.doc

Physicians have taken an oath to 'First do no harm'. LASIK harms.

I suffer from LASIK-induced dry eye and am in contact with patients who are disabled by LASIK dry eye.

A follow-up to this study by the Mayo Clinic shows that nerve density returns to preop levels at about 5 years for LASIK, and about 3 years for PRK.

Of course nerve density is not nearly so important as nerve sensitivity. The vast majority of patients have nerve sensitivity return within the normal six-month healing period.

Several recent studies have shown that a thinner LASIK flap (about 100 microns) tends to cause LASIK induced temporary dry eye less often. Doctors are also moving toward surface ablation techniques like PRK, LASEK, and Epi-LASIK that are less disruptive to the corneal nerves.

People who have preop dry eyes or are predisposed to dry eyes need to be careful about any cornea-based refractive surgery technique and discuss potential problems with their doctor.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.

Thanks for your informative replies Glenn...please provide any additional information that you have regarding posts from "Eye"...her posts are scary...

I would gladly respond with researched, objective, and accurate information to any specific question that may directly affect a patient. I find that responding to unsolicited errata that is not germane from a person who knows only one bias is an exercise in futility.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.