Dry eye after LASIK laser eye surgery is common and typically temporary. It can be minimized by using lubriant drops, Restasis, Azasite, and oral omega-3 supplements, including flax seed oil and fish oil.
Temporary dry eye is very common after both LASIK and PRK laser eye surgery. Some researchers feel that PRK produces somewhat less of a dry eye than LASIK does. The cause of dry after after LASIK and PRK is the same, however.
There are nerves that run along the surface of the cornea that tell the cornea when it is getting dry and irritated. These corneal nerves therefore tell the eye when it is time to blink and to tear. After LASIK, these nerves need to grow back, which takes approximately six months. During this time, the eye is actually less sensitive. While it can still feel irritation to some degree, it is not as readily stimulated to blink and tear, which makes it easier for the eye to dry out. For example, when you use a computer, you tend to blink less as you stare at the screen. As you are staring at the screen, your tears start to evaporate off of the surface of your eye. When the eye finally gets dry enough, you unconsciously blink and tear. After LASIK laser eye surgery, if you are using the computer, you will eventually blink and tear, but it will take longer before your eye is stimulated to do so because the surface of the eye is less sensitive. This means that your eye will have a greater chance to dry out.
The dry eye, which results from this temporarily decreased stimulation to blink and tear after surgery, can be treated in several ways. The most simple way is to compensate for the reduced rate of blinlking and tearing by using lots of lubricants drops until your corneal nerves grow back after LASIK. I find Systane Ulta, Systane Gel, Systane Balance, and Refresh Celluvisc to be particularly helpful lubricating eye drops. Each patient typically finds their favorite eye drop that works best for their needs.
Additionally, studies have looked at the role of a drop called “Restasis.” Restaisis is a twice a day medicated eye drop approved by the FDA to treat people who already have dry eye and, in fact, most people using Restasis have never had LASIK — they just have dry eyes. Post-menopausal women in particular tend to have dry eyes and benefit from Restaisis. Studies show that using Restasis in the setting of LASIK can help reduce the dry eye which can be seen after LASIK laser eye surgery. I place all of my patients on Restasis both before and after LASIK and I have definitely found using it helps to minimize the dry eye which can be seen after LASIK.
Another prescription eye drop can also be useful. Azasite is a new generation antibiotic that I typically place my patients for two weeks before surgery to clean the eye and help reduce the risk of infection. As an additional — and “off label” benefit, Azasite helps to stabilize the tears of the eye and keep them from evaporating off the eye as quickly. Strategic use of Azasite can also help minimize the dry eye seen after LASIK by reducing tear evaporation.
Additionally, oral omega three replacement can help improve tear quality and also reduce the degree of dry eye after LASIK laser eye surgery.
For most people, if properly treated, the dry eye after LASIK tends to be a minor problem which gets better within six months.
See Also
Restasis Website
Manufacturer’s website for Restasis. Restasis is a drop which can help reduce dry eye after LASIK laser eye surgery.
Azasite
Prescribing insert information for Azasite ophthalmic eye drops.
Azasite to Treat Dry Eye
Azasite is approved by the FDA for use as an antibiotic drop. This medical article discusses the off label use of Azasite to treat dry eye.
Systane
The manufacturer’s website for the Systane line of lubricating eye drops. I find that Systane Ultra, Systane Gel, and Systane Balance work particularly well as treatments for dry eye after LASIK or PRK laser eye surgery
Refresh Lubrication Drops
The manufacturer’s website for the Refresh line of eye drops and ointment. I find that Refresh PM and Refresh Celluvisc work particularly well for dry eye after LASIK or PRK laser eye surgery.
Theratears Nutrition
The manufacturer’s website for Theratears Nutrition Omega-3 capsules. Theratears capsules contain both flax seed oil and fish oil which, in combination, work well to minimize dry eye after LASIK or PRK.
American Academy of Ophthalmology Overview of LASIK
An overview paper by the American Academy of Ophthalmology of LASIK and PRK, including discussions of dry eye.
FDA LASIK Website
The FDA LASIK Website discusses dry eye issues after LASIK laser eye surgery
LASIK Associated Dry Eye
This article from the medical literature looks at the casuses of, and treatments for, dry eye after LASIK
Dry Eye After PRK
This article from the medical literature looks at dry eye after PRK
Dry Eye
This article presents a twenty five year review of the diagnosis and management of dry eye of various causes