LASIK- Laser Assisted In-Situ Keratomileusis is the most common type of laser eye surgery. Its used to treat nearsightedness, farsightedness and astigmatism.
According to FDA, USA the procedure entails many unavoidable risks and complications in some patients. The most common complication is dry eyes.
Contents of this article:
- What is LASIK?
- Why might LASIK lead to dry eyes?
- Who is most at risk?
- Treatment and prevention of dry eyes following LASIK
What is LASIK?
This procedure involves numbing the eye and then propping the eyelids open with lid speculum. Then the surgeon creates a thin flap in the cornea which is temporarily folded away. With the help of a computer-controlled laser, pulses of light are focused on the eye and these reshape the cornea. Finally, the surgeon repositions the corneal flap and this heals on its own.
Why might LASIK lead to dry eyes?
The most common complication of LASIK is dry eyes. A 2011 study noted that 95% of patients develop some degree of dryness immediately after having the procedure, with a small proportion of patients developing chronic dry eyes that do not respond to traditional treatments. 60% of patients still report dry eye symptoms 1month after having LASIK. The symptoms usually peak in the first few months after surgery and subsided around 6months following surgery.
Possible reasons suggested by experts:
1.Damage to corneal nerves. Nerves in the eyes are disrupted both when the LASIK surgeon creates a flap and when the laser reshapes the cornea.
2.Damage to cells called as goblet cells.
3.Inflammation to the nerve endings in the eye after the procedure, may make the dry eye symptoms worse.
4.The change in the shape of the cornea in LASIK may alter the fit of the eyelid against the eye surface. This could lead to tears being distributed unevenly over the eye when blinking.
Who are at risk?
People who already have symptoms of dry eye before procedure are at more risk, however individuals at East Asian ethnicity, contact lens wearers, people with chronic eyelid conditions, certain immune disorders and diabetes are also likely at risk.
Treatment and prevention of dry eyes following LASIK
- Conventional therapy for dry eyes work for most patients undergoing this procedure.
2.Lubricant eye drops known as artificial tears are usually first treatment a doctor would recommend. Although some patients may not respond sufficiently to artificial tears.
3.A procedure called Punctual Occlusion– in which silicon or collagen plugs are inserted into an area of the eye aiming to keep tears in the eyes for a longer period. This procedure is done by experts and can be reversed.
4.Anti-inflammatories are often used to treat moderate to severe symptoms of inflammation,
5.Cyclosporine eye drops have been found to increase tear production, decrease inflammation and raise the number of goblet cells.
6.Scleral lens are wider than normal contact lenses, they lie on the white part of the eye and help to keep eyes moist by holding a reservoir of fluid between the lens and cornea.
Other complications following LASIK:
- The creation of corneal flap could cause infections, excess tears and inflammation.
- Other complications associated includes not being able to see as sharply or clearly as before or rarely losing vision. Vision might also return to pre-surgery levels slowly. This could happen in patients who are pregnant or those with hormonal imbalances.
- Glare, halos around bright light and double vision have also been reported.
- It is possible that the laser could under- or overcorrect vision if too little or too much tissue is removed from the eye.
- Under-corrections are more common among people who are nearsighted who have LASIK. Overcorrections tend to be more difficult to fix than under-corrections.
Alternatives:
Orthokeratology otherwise known as overnight vision correction is one alternative to laser eye surgery. Practitioners claim that this method gives the benefit of LASIK without surgical risks. It involves wearing specially designed contact lenses during the night while asleep. These custom-built contact lenses reshape the cornea to correct vision. It usually takes 1-4 weeks for results and the results are not usually permanent. They need to be worn intermittently as a result. A recent systematic review concluded that it is a safe and effective treatment if lenses are fitted properly and lens care regimens are strictly adhered to. One of the most common complication is staining of the cornea.