Dry eye, moderate and transient, is undoubtedly the most frequent complication of laser surgeries performed using the Lasik technique, whether for myopia surgeries or presbyopia surgeries.
It is explained by the section, during Lasik or prk eye surgery near me, of the intra-corneal nerve endings, which break the reflex arc between corneal sensitivity and the production of tears by the lacrimal glands. In the normal state, any irritation perceived by these nerve endings results in an increased production of tears. In the immediate aftermath of Lasik, the loss of corneal sensitivity linked to the nerve section thus results in a decrease in tear secretion. The gradual regrowth of these nerve endings in the weeks following Lasik surgery leads to the reduction and disappearance of the induced dry eye. The dryness is usually less important in the all-laser Lasik technique, using the femtosecond laser, because the cut corneal flap is thinner than in classic Lasik, thus making the nerve section more superficial.
For the vast majority of patients, this dryness is transient, lasting only a few weeks, and causing little perception for the patient due to the systematic prescription of tear substitutes in the form of more or less thick eye drops and more or less viscous. However, during the first postoperative weeks, it may be difficult to accurately assess the result of the surgery because significant dryness may be accompanied by disturbances in vision, which disappear as soon as corneal hydration has returned to normal. A normal level. It is, therefore, often necessary, at this stage, to reassure the patients of a visual result that they consider imperfect and, above all, not to rush into unnecessary retouching.
When Lasik surgery with discover vision center for example is performed in hot and dry weather, it is often necessary to prolong the prescription of artificial tears a little longer.
Moderate corneal dryness before surgery is not a contraindication to Lasik because this situation is quite common among contact lens wearers who develop an intolerance to lenses, leading them to request an operation of myopia. Dry eye is often one of the components of intolerance to contact lenses, and intolerance to contact lenses is one of the situations motivating surgery for patients who do not wish to return to wearing glasses.
On the other hand, care should be taken in patients with drug-induced dry eye, especially if it is related to anti-acne treatment based on acidic vitamin A derivatives. In these patients, it is preferable to postpone surgery because these treatments are not prescribed for the long term but only for a few months.
Be that as it may, and despite the selection of indications, significant corneal dryness may be observed, accompanied by bothersome functional signs and considerable visual difficulties. In these situations, it may be necessary to insert silicone punctal plugs. Their principle is simple: by blocking the path of elimination of tears, these plugs make it possible to “profit” a little more from the small number of tears produced. These plugs are very easy to put in the consulting room and can be left in place for several months when they are not spontaneously lost. Removing them is just as easy as putting them in place.
In exceptional cases, we can observe in some patients the persistence of ocular dryness leading to leaving the plugs in place while ensuring prolonged supplementation with artificial tears.