Dry Eyes after LASIK
Overview
One of the most common complications of LASIK or other types of refractive surgery is dry eye. Many patients experience some degree of dry eye after surgery. Sometimes this is temporary and sometimes it can be severe and remain a permanent lifelong condition.
Details
Data shows that after virtually all patients experience some sort of dry eye after Laser eye surgery:
- 6 months after surgery 20% of patients continue to report dry eyes.
- Other studies have suggested that 30-50% of patients still continue to experience severe dry eye 1 year post surgery.
The tear film consists of three layers–an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye; a middle (aqueous) layer that nourishes the cornea and conjunctiva; and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet.
Research points to corneal nerve damage as the most likely cause of dry eyes after LASIK. The nerves of the cornea that play a vital role in tear production are severed when the flap is cut and ablated by the laser during the surgical procedure. Other factors which may contribute to dry eyes after LASIK includes damage to the conjunctival goblet cells which impairs the mucin layer of the tear film, and central corneal flattening after LASIK, resulting in insufficient tear wetting and clearance as the eyelids move across the altered corneal surface.
Diagnosis
Dry eye is diagnosed by a Optometrist, Ophthalmologist or other specialist looking for the presence of multiple indicators. Such as:
- A Schirmer test score less than 5 mm
- Tear film breakup time of less than 10 seconds
- Rose bengal staining higher than 3
- Fluorescein staining higher than 1
These observations are considered indicative signs of dry eye disorder.
Treatment
Dry eye disorder are very successfully treated with Laserfit scleral lenses. This is due to the fact that the scleral lens reservoir is filled with a thin layer of soothing tear like liquid that keeps the cornea constantly wet. This brings a significant amount of relief to patients suffering extreme dry eye disorder.
