Dry Eye After LASIK Laser Eye Surgery

LASIK typically makes the eyes drier for six months after surgery, but several measures can minimize post-operative dry eye after LASIK laser eye surgery. A patient from Camarillo asked me a good question today. She wondered if LASIK laser eye surgery caused dry eyes.

LASIK does, in fact, cause the eyes to become dryer, typically for approximately 6 months after surgery. Fortunately, we now have several methods to reduce the dry eye seen after LASIK surgery.

The reason for dry eye after LASIK laser vision correction primarily is that there are nerves on the surface of the cornea which need to grow back after LASIK, which typically takes six months. These nerves tell the eye when it has become dry and irritated — and when it needs to blink and tear. Until these nerves grow back, the eye is actually less sensitive. For example, if you stare at your computer after LASIK surgery, your automatic and unconscious message to blink and tear as your eye gets dry won’t “kick-in” as well. For this reason, your eye will tend to “run dry” after surgery.

Patients can compensate for this by using lubricant drops. I find several over-the-counter lubricant drops to be particularly effective after LASIK, including Refresh Celluvisc, Systane Gel Drops, Systane Balance, and Systane Ultra. These drops are purely lubricants and have no medicine in them. For this reason, there is no limit to how often you can safely use them after LASIK. Generally, patients need to use these drops most frequently for the first month or so after surgery, particularly when using computers, tablets, or hand held devices after LASIK which involve lots of staring at a screen.

Studies have also looked at a prescription, medicated eye drop called “Restasis” in the setting of LASIK laser eye surgery. Restasis currently is the only FDA approved medicated drop used to treat people with dry eyes and hundreds of thousands of patients who have never had any eye surgery at all are placed on Restasis by their eye doctor for dry eye each year. Both studies and clinical experience show that the use of Restasis both before and after LASIK can help minimize the post-operative dry eye we see and also improve surgical outcomes of LASIK. For this reason, I put all of my patients on Restasis, typically for 2 weeks before laser eye surgery and for 3 to 6 months afterwards. I definitely have found that the use of Restasis with LASIK greatly improves the dry eye typically seen after LASIK.

Another drop that can be helpful to minimize dry eye after LASIK is an antibiotic drop called “Azasite.” Azasite has an additional benefit beside being an antibiotic in that it improves the quality of tears, mostly by improving the oil layer (top layer) of the tears and minimizing evaporation. This is particularly helpful after LASIK as blink rates are thought to be lower until the corneal nerves grow back, so slowing down the rate of tear evaporation is important.

Finally, another measure that can help dry eye after LASIK laser vision correction surgery is the use of oral omega-3 supplements. I prefer a mixture of vegetarian omega-3 (ALA) and fish oil (DHA and EPA). A particularly good source is an over the counter pill called “TheraTears Nutrition.” I find that use of oral omega-3 supplements helps to minimize post-operative dry eyes and I recommend them to all my patients. There is even some data to suggest omega-3 directly can improve corneal nerve regeneration after LASIK. And, of course, omega three is good for you as well!

Using these and other measures, I have found that the issue of dry eye after LASIK has become significantly less of a problem than it had been in the past.

Dry Eye After LASIK Laser Eye Surgery

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