Dry eyes have become a very common problem even without lasik surgery. What earlier used to affect some select few and mostly was a problem of older age groups with some systemic diseases has now become a common problem. We now give treatment for dry eye to children who are glued to mobile and computer screens, young professionals who work twenty four seven on the computer monitors and ofcourse older people who have dry eye due to other reasons. So I am really talking about no age being excluded from the problem of dry eyes.
Every week at Centre for Lasik Surgery @ Advanced Eye Hospital and Istitute, Navi Mumbai, india we see young professionals who visit us to explore the option of getting LASIK laser surgery. And given that dry is so common, a lot of them have dry eyes. On top of that dry eye is even more common in regular contact lens users.
So what is the connection between Dry eye and lasik laser surgery? Does it affect recovery from lasik surgery?
- Dry eye is the most common problem after LASIK and virtually all patients experience dry eyes after LASIK for the first 3-6 months. This happens due to damage to the corneal nerves while corneal flaps are being made as a part of the conventional or FEMTO LASIK procedure.
- Dry eyes can delay normal healing after the LASIK surgery
- Dry eyes after LASIK can cause both discomfort and less than optimal visual outcomes.
- Long standing uncorrected dry eye after Lasik can cause regression ( some numbers to come back)
Since the post procedure stakes with dry eyes are high, we make sure provide best treatment for dry eye before lasik surgery. A battery of dry eye tests is performed to assess the presence and grade the severity of dry eyes during Pre LASIK evaluation. Both the quality and quantity of tear film is evaluated.
Various tests for dry eye before lasik surgery that are performed include–
- Schirmer’s test- In this test a thin strip of special paper is putting under the lower lid to measure the amount of tear production.
- Tear break up time- This is done with the help of a special dye which is put on the eye surface and then tear distribution and break up is evaluated
- Surface staining- This is also done with the help of the dye and any areas of surface staining are studied.
- Imaging- to assess the anatomy of the gland in the lids called Meibomian glands
While assessing the possible candidate for a LASIK procedure, we also try to rule out if there is any underlying condition that might be causing dry eyes.
Sheila, a young housewife wanted to learn swimming and found her glasses a big hindrance to that. She decided to get rid of her glasses and came to us for evaluation at the Center for LASIK surgery at Advanced Eye Hospital and Institute, Navi Mumbai. All her pre-LASIK evaluation was completely normal except for moderate decrease in her tear secretion. We noticed the slight crookedness of the fingers. On further probing she revealed that sometimes she gets pain and swelling in her fingers but she has not taken any treatment for it. We ordered some blood tests and she turned out to be a case of Rheumatoid Arthritis. This causes dry eye and can hamper normal healing after LASIK. She was advised against LASIK as there would have been risks of lasik surgery in long term.
Who are the people who are most at risk of developing dry eyes after LASIK?
- Pre-existing dry eye (for example long term contact lens users)
- People with very high myopia who need deeper tissue ablation during LASIK
- Autoimmune diseases like Rheumatoid Arthritis, SLE, Sjogrens syndrome, skin diseases
- Post menopausal women
- People on some systemic medicines like Allergy medications
Can lasik be done if someone has dry eye?
All patients who have dry eyes may not be unfit for lasik. If the dry eye is mild to moderate, we may consider treatment for dry eye prior to LASIK. In some cases we put punctual plugs, small plugs to block the tear drainage from the eye and hence enhance the eye lubrication, at the time of LASIK laser surgery.
Which is the best lasik surgery for people with dry eye?
As lasik surgeons, we regularly make a choice when managing patients who have dry eye prior to lasik treatment such as:
- Surface Ablation (PRK, LASEK, Epi-LASIK) and SMILE LASIK (also called Relex Smile) are better options to prevent and reduce dry eye problem compared to LASIK.
- SMILE LASIK vs Lasik/ Femto Lasik, where no flap is created and is bladeless, causes minimal damage to corneal nerves during the procedure compared to LASIK where due to flap creation more corneal nerves are damaged. Hence, dry eye is less after Smile lasik.
To summarise:
- All people who are keen on LASIK should get a detailed pre LASIK dry eye check up done. Hence, it is a routine at Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai.
- Mild to moderate dry eyes require best treatment for dry eye before lasik surgery procedure.
- Newer, more advanced options like Relex SMILE LASIK have best results and reduce the problem of dry eye after the laser vision correction.
About the Lasik Surgeon:
Dr Vandana Jain is a renowned Cornea Surgeon and one of the best Lasik Surgeons in India. She has been trained in Cornea and refractive surgery at LV Prasad Eye Institute Hyderabad and then at Harvard USA. She has performed more than 5000 successful Lasik Surgeries and heads one of the best lasik centres in India- Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India. Centre for lasik surgery at AEHI has the best lasik surgery machines for conventional lasik, femto lasik and Relex smile lasik available in India.
Dr Vandana Jain – Expert Lasik Surgeon
Watch dr Vandana Jain perform Smile lasik Surgery – the best Lasik surgery at Centre for lasik surgery, AEHI, Navi Mumbai, India
Watch video of Dr Vandana Jain, Best Lasik Doctor, answering questions about Smile Lasik surgery- safest lasik surgery
Dr Vandana Jain can be contacted at contactus@advancedeyehospital.com or her appointments are available at +91-22-67313636
Dr Vandana Jain, Cornea and Lasik Surgeon, Mumbai, India 