Post-LASIK dry eye disease: A comprehensive review of management and current treatment options

Frontiers in Medicine · 13 authors, 11 centres

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TL;DR

This narrative review synthesizes existing literature on the management and treatment of dry eye disease (DED) following LASIK refractive surgery.

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This narrative review examines the management and treatment of dry eye disease (DED) following laser-assisted in situ keratomileusis (LASIK) and other refractive surgeries. The authors describe DED as the most common post-LASIK complication, noting that nearly all patients develop some degree of postoperative dryness that can persist for up to one year or become chronic. The review covers differences in DED incidence across surgical techniques, reporting that SMILE shows better DED recovery than femtosecond laser (FS) and microkeratome (MK) approaches within the first three months. Therapeutic options discussed include preservative-free artificial tears, punctal plugs, autologous serum, cyclosporine, scleral lenses, and oral medications. The authors emphasize that preoperative detection and treatment of existing DED is the most significant factor in reducing postoperative complications.

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narrative_review

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ophthalmology

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ORIGINAL PAPER

PMC10126282

Post-LASIK dry eye disease: A comprehensive review of management and current treatment options

Frontiers in Medicine

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ABSTRACT

Laser-assisted in situ keratomileusis (LASIK) is a unique corneal stromal laser ablation method that uses an excimer laser to reach beneath corneal dome-shaped tissues. In contrast, surface ablation methods, such as photorefractive keratectomy, include removing epithelium and cutting off the Bowman’s layer and the stromal tissue of the anterior corneal surface. Dry eye disease (DED) is the most common complication after LASIK. DED is a typical multi-factor disorder of the tear function and ocular surface that occurs when the eyes fail to produce efficient or adequate volumes of tears to moisturize the eyes. DED influences quality of life and visual perception, as symptoms often interfere with daily activities such as reading, writing, or using video display monitors. Generally, DED brings about discomfort, symptoms of visual disturbance, focal or global tear film instability with possible harm to the ocular surface, the increased osmolarity of the tear film, and subacute inflammation of the ocular surface. Almost all patients develop a degree of dryness in the postoperative period. Detection of preoperative DED and committed examination and treatment in the preoperative period, and continuing treatments postoperatively lead to rapid healing, fewer complications, and improved visual outcomes. To improve patient comfort and surgical outcomes, early treatment is required. Therefore, in this study, we aim to comprehensively review studies on the management and current treatment options for post-LASIK DED.

CITATION EXPORT

Atena Tamimi, Farzad Sheikhzadeh, Sajjad Ghane Ezabadi et al.. Post-LASIK dry eye disease: A comprehensive review of management and current treatment options. Frontiers in Medicine. (2023). https://doi.org/10.3389/fmed.2023.1057685

AUTHORS

13 · 11 CENTRES

Atena Tamimi, Farzad Sheikhzadeh, Sajjad Ghane Ezabadi, Muhammad Islampanah, Peyman Parhiz, Amirhossein Fathabadi, Mohadeseh Poudineh, Zahra Khanjani, Hossein Pourmontaseri, Shirin Orandi, Reyhaneh Mehrabani, Mohammad Rahmanian, Niloofar Deravi

1Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
4Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5Student Research Committee, Zahedan Medical Sciences Branch, Islamic Azad University, Zahedan, Iran
6Student Research Committee, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
7School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
8Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
9Bitab Knowledge Enterprise, Fasa University of Medical Sciences, Fasa, Iran
10Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
11Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran