Speaker: Treat preexisting dry eye disease before LASIK
BOSTON – Dry eye is one of the most common complications of LASIK surgery, but severity is worse in prior dry eye disease patients, according to a speaker here.
Postoperatively, occurrence of dry eye peaks at 1 week to about 3 months, regardless of prior dry eye disease, and chronic dry eye disease occurs in about one in five post-LASIK patients and in about 3% to 7% post-PRK patients, Elizabeth Yeu, MD, told colleagues at Cornea Day preceding the American Society of Cataract and Refractive Surgery annual meeting.
Symptoms include fluctuating vision, decreased best spectacle corrected visual acuity, discomfort and regression of treatment.
“The etiology isn’t perfectly clear,” she said, listing a neurotrophic component from transection of the nerves, neurotoxicity from the excimer laser, direct damage to goblet cells from the microkeratome, altered corneal curvature and tear film coverage, and a cyclical cascade of inflammation and desiccation of the ocular surface as etiologic agents of post-LASIK dry eye disease.
“A healthy stable tear film is essential for high-quality visual function and stable interblink vision,” Yeu said. “Treat medically first and then procedurally with thermal pulsation, chalasis or cauterization. If dry eye disease does not resolve, the patient is a poor candidate for corneal refractive surgery.”
Disclosure: Yeu is a consultant for Abbott Medical Optics, Allergan, Bausch + Lomb, Nicox and TearLab. She is on the speakers bureau for Alcon and Allergan.