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If Dry Eyes Still Persist, What Could Have Happened During Lasik to Cause It?

Should I try a different kind of eye drop if my dry eyes are still a problem 4 months after Lasik? Are my eyes still healing, is that why they are dry? Is something else causing the dry eyes this long after surgery? 

Doctor Answers (1)

Dry eyes after incisional surgery like LASIK or IntraLase

+1

everybody gets at least some degree of dry eyes after any type of incisional refractive surgery, such as LASIK or IntraLase. the reason is that when i cut a corneal flap, i also cut your corneal nerves. this causes dry eyes for 2 reasons. first, the nerves actually secrete special substances that prevent dry eyes. second, your eye is then relatively anesthetic because you're missing most of the nerves, and they never grow back fully, so your blink rate decreases. we have done studies on this, which prove people post-LASIK are actually unconsciously staring their eyes dry, because they have an abnormally slow blink rate. the normal blink rate is 1 blink every 5-10 seconds. post-LASIK, i've seen patients who blink every 15 seconds.

this is why i switched to non-incisional, non-cutting, non-invasive LASEk and epi-LASEK 6 years ago, as they don't need a flap to be cut, so the nerves are not cut in half, so the chance of permanent dry eyes is vastly reduced. we had a doctor visiting from Egypt yesterday, and one of my 5 MD fellows from India wanted to know from him "what % of your patients post-LASIK complain of dry eyes?" he said 50% (at least mildly). she said, "wow, in our LASEK practice, we get that complaint at most 5% of the time!"

after my own LASIK, i had permanent dry eyes. you will need permanent punctal plugs or cautery, which solved the problem for me. just tell your eye surgeon that, and he or she will take care of it

but tell your friends that before they get LASIK they should at least check out Advanced Surface Ablations or ASA, namely LASEK or epiLASEK

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