Dry Eyes
Risks of LASIK
Patients who suffer persistent dry eyes or other problems after LASIK should file a MedWatch report with the FDA online. Alternatively, you may call FDA at 1-800-FDA-1088 to report by telephone.
FDA warns: Some patients may develop permanent, severe dry eyes after LASIK
From the Food & Drug Administration (FDA) website: “Some patients may develop severe dry eye syndrome [after LASIK]. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.” Link to FDA web page
Learn the facts about dry eyes after LASIK
Dry eye is the most common complication of LASIK and the most common reason for dissatisfaction with the surgery.
Corneal nerves which play a vital role in tear production are damaged during LASIK surgery. As a result, virtually every LASIK patient experiences dry eyes after the surgery — in some cases permanently.
In the early post-operative period after LASIK some patients may not sense that their eyes are dry because of corneal nerve damage-related loss of sensation.
Researchers have found that even ten years after LASIK corneal nerves do not fully return to normal. (Source: Garcia-Gonzalez et al.Long-term corneal subbasal nerve plexus regeneration after laser in situ keratomileusis. J Cataract Refract Surg. 2019 Jul;45(7):966-971.)
For some LASIK patients, dry eyes can be managed with artificial tears, but other patients suffer severe, intractable symptoms. Moreover, a subset of LASIK patients develop chronic corneal nerve pain, also known as corneal neuralgia or corneal neuropathic pain.
LASIK surgeons who assert complication rates of 1% or less completely disregard the potentially debilitating complication of dry eyes. In a 2017 study, FDA researchers found that up to 28% of patients with no symptoms of dry eyes before LASIK developed dry eye symptoms after the surgery. (Source: Eydelman et al. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmol. 2017 Jan 1;135(1):13-22.)
Treating post-LASIK dry eyes
If you suffer dry eyes after LASIK, you should tell your eye doctor. Typical treatments include preservative-free artificial tears, omega−3 fatty acid supplementation (e.g. fish oil), daily cleaning of eyelids and eyelashes, and daily warm compresses to help release oil from glands along the rim of the eyelid. More aggressive treatments include tear duct plugs to slow drainage of tears, moisture chamber goggles to slow evaporation of tears, nighttime ointments or gels, dry eye sleeping masks, prescription eye drops (e.g. cyclosporine, lifitegrast and corticosteroids), autologous serum tears (eye drops made from your own blood), and amniotic membrane grafts. Additionally, some eye doctors provide in-office procedures for dry eyes. (This is not an all-inclusive list.)