What eye drops do you recommend following LASIK? Will Visine be fine? How long are they needed?

There are several drops that need to be used after LASIK.  Simply using visine is neither recommended nor sufficient.  It is best to discuss the post-op regimen with your surgeon since everybody uses a different drop schedule.

Branded postop drops are so important in my practice that we provide them to every patient (this way I don’t need to worry about pharmacies switching out my meds). A strong anti inflammatory steroid (like durezol/difluprednate) 2x per day for 7 days, preservative-free moxifloxacin (antibiotic) 4x per day for 5 days, and preservative-free artificial tears 4x per day for 1 month (or more if needed). Preserved drops (any drop in a bottle) are prohibited the first month, including visine/opconA/cleareyes. If your eyes are red after surgery there is likely a good reason for that (dry eye, rebound off of the aforementioned drugs, etc). So if you stick to the proper regimen and still have irritated red eyes then I would likely advance therapies to other pharmaceuticals. 

LASIK entails creation of a thin flap of corneal tissue. At the end of the procedure the hinged flap is returned to its original position and smoothed out providing for quick visual recovery. The process of flap creation severs nerves innervating the corneal surface. These nerves are responsible for sensing how well lubricated the ocular surface is at any given time. Depending on the age of the patient (younger faster) it may take from 3 to 12 months to regenerate completely. While the regeneration is in progress the eye is not as good at sensing when it is dry and when it's not. While this auto regulation of tear production is compromised its is best to support the ocular surface with exogenous lubricants.Visine while effective in whitening the conjunctiva, is not a lubricant. In fact it may contribute to further drying the ocular surface. In general artificial tears come in 2 varieties preserved and non preserved. Tears that are packaged in bottles (multiple use) must contain a preservative, which may be irritating to the ocular surface if used more frequently than 4-5 times a day. This may be fine a few weeks after surgery when one doesn't need to administer tears frequently. In the most immediate postoperative period, when more frequent lubrication is needed, e.g. every 1-2 hrs, non preserved tears are best. These come in single dose dispensers that are discarded after one use.here are many good brands and include Systane, Optive, Refresh and many others.

You will use a steroid drop, and antibiotic drop, and a non-steroidal anti-inflammatory drop for about a week after your LASIK. After that it is best to use artificial tears for up to six months to avoid dry eyes. Please do not use Visine! It is toxic to the cornea. Visine brand artificial tears are fine.

most patients after LASIK or IntraLase, which are the older, cutting procedures, develop at least some degree of dry eyes, because when you cut the corneal flap, you cut the corneal nerves, which is the cause of dry eyes. i have some DES (dry eye syndrome) myself because I have had LASIK.

this is one of the reasons i switched to ASA (Advanced Surface Ablation), which are LASEK and epiLASEK, as these are noncutting, so do not cause dry eyes.

after LASIK, you're going to need to use artificial tears for the rest of your life. it's not a big deal, and i'm still glad I had LASIK, but i definitely need to use tears every day in the winter when it's dry, less often in the spring and fall, and not really in the summer.

you should NOT use drugstore brands, generics, or Visine. Visine and similar products contain vasoconstrictors to "get the red out" which is NOT what you need. it may even make your dryness worse.

what you need to use is a high-quality tear, by one of the large eye companies, like Allergan, Alcon, or Bausch & Lomb. these products are a bit more expensive, but worth it, as the contents are different. for example, some of the thicker products contain hyaluranic acid, which is a viscoelastic substance that we use in cataract surgery, derived from rooster combs (they are jelly-like)

in any case, immediately after surgery you should use a preservative free tear that's in an individual vial, as frequent use of a preserved product can cause allergic reactions.

 

anything in a bottle, by law, by FDA, MUST contain a preservative. so don't believe the bs marketing stuff you're going to see, where you see some product in a bottle that is marketed as "preservative free on contact." that's a bottle with preservatives in it, that get degraded by the corneal esterases in your cornea on contact. well, guess what--the drop already contacted your eye, so any sensitivity to that preservative will already be triggered

in summary, i think it's bad advice for anyone to say that it's ok if you take Visine after LASIK. you should use a high-quality, preservative free tear. the other doctor who suggested Restasis is correct, in that is sometimes useful to "restart" your natural tear function. after a few months, it should be back to normal, and you can stop your Restasis, decrease your tear frequency, and then go into a bottled product (but not Visine or a drugstore brand)

it also helps if you drink more water, decrease alcohol and caffeine consumption, and get a "cool mist" humidifier when you sleep, especially in the northeast in the winter, where it's very dry

hope this helps, and don't worry, you'll be fine!:)

As soon as a flap is made essentially everyone gets dry eyes after LASIK.  For that reason, we suggest that patients start on a drop called Restasis which increases your own natural tear production as soon as possible before surgery.  Many patients are sensative to preservatives early after surgery and we recommend tear drops without preservatives for the first week after surgery.   After the first week, most people can use tear drops with preservatives or without.  The key is to use them with adequate frequency and in general, most people have better vision after surgery when they use lubrication at least every hour or two for the first several weeks.

Visine makes lubricating drops as well as allergy or decongesting (gets the red out) drops and both can be used safely.  Many patients use artificial tears occasionally after LASIK, but often need allergy eye drops or other eye drops for other eye-related conditions.  In general eye drops of all sorts are safe to use after LASIK.

I usually recommend an antibiotic and steroid eye drop for the first five to seven days after surgery.  After this, preservative free tears are recommended for dryness as preservatives may cause toxicity to the epithelium or front surface of the cornea and induce more fluctuating vision.

I have all of my patients use an antibiotic eye drop the night before LASIK surgery and for 5 days afterward. I have never  had an infection with this protocol(70,000 eyes) and I will continue this indefinitely. I also have patients use a steroid eye drop twice a day for 5 days. This helps speed along recovery. Lubricating eye drops(tears) are used as needed for the first week or two. Some patients use these alot, others don't use them at all. I don't recommend Visine right after surgery because of the preservatives.....so we will give you some other wetting drops to use.