To review the pathophysiology of LASIK-associated dry eye conditions and provide insights into prophylaxis to decrease the
incidence of dry eye after LASIK and to treat the condition when it occurs.
A review of the literature was performed on LASIK-associated dry eye and the experience of the authors was summarized.
LASIK has a neurotrophic effect on the cornea, along with other changes in corneal shape, that affect tear dynamics causing
ocular surface desiccation. Dry eye is one of the most common complications of LASIK surgery. Symptoms of dryness may occur in more than
50% of patients, with other complications such as fluctuating vision, decreased best spectacle-corrected visiual acuity, and severe
discomfort occurring in approximately 10% of patients. Preoperative dry eye condition is a major risk factor for more severe dry eye
after surgery and should be identified prior to surgery. Optimization with artificial tears, nutrition supplementation, punctal
occlusion, and topical cyclosporine A in patients with symptoms or signs of dry eye prior to LASIK decreases the incidence of more
bothersome symptoms following surgery. Patients with LASIK-induced neurotrophic epitheliopathy often respond to topical cyclosporine A
treatment, which treats the underlying inflammation and may benefit nerve regeneration.
LASIK-induced dry eye and neurotrophic epitheliopathy are common complications of LASIK surgery. Optimization of the ocular
surface prior to surgery decreases the incidence and severity of postoperative symptoms of the condition. [J Refract Surg.
ABOUT THE AUTHORS
From the Department of Ophthalmology, Fluminense Federal University, Niterói, and Instituto de Olhos Renato Ambrósio, Visare Personal Laser and Refracta-RIO, Rio de Janeiro, Brazil (Ambrósio); Helsinki University Eye Hospital, Helsinki, Finland (Tervo); and Cole Eye
Institute, Cleveland Clinic, Cleveland, Ohio (Wilson).
Supported in part by grant EY10056 from the National Eye Institute and Research to Prevent Blindness, New York, NY (Dr Wilson).
Dr Wilson is a consultant for Allergan. The remaining authors have no proprietary interest in the materials presented herein.
Correspondence: Steven E. Wilson, MD, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195. Tel: 216.444.5887; E-
Received: February 2, 2006
Accepted: March 19, 2007
Posted online: September 15, 2007