To print: Select File and then Print from your browser's menu---------------------------------------------------------------------------------------Title: LASIK Patients at Risk for Long-Term Eye Irritation URL: http://www.pslgroup.com/dg/1FF9FA.htmDoctor's GuideJune 29, 2001
SAN FRANCISCO, CA -- June 29, 2001 -- Patients considering LASIK (laser in situ keratomileusis) should be informed of the risk of developing ongoing ocular irritation symptoms similar to dry eye. This is the recommendation of the authors of a study in the July 2001 issue of Ophthalmology, the clinical journal of the American Academy of Ophthalmology, the Eye M.D. Association.
Also, LASIK patients with reduced ocular sensitivity from long-term contact lens wear may take years to regain normal ocular surface sensitivity, if ever.
In this prospective, non-comparative case series, the authors evaluated 48 eyes of 14 men and 34 women who underwent bilateral LASIK for myopia or myopic astigmatism, and found that desensitization of the surface of the eye after LASIK disrupts tear production and causes ongoing irritation.
Lisa Battat, M.D., Director of Cornea and Refractive Surgery, Everett and Hurite Ophthalmic Association, lead author of the study, explains: "Despite their decrease in ocular surface sensitivity to touch, the patients in our series paradoxically reported an increase in ocular irritation symptoms. A similar phenomenon has been observed in dry eye patients, who have also reported significantly reduced ocular surface sensitivity. The cause has not been established, but it may be due to sensitization of the traumatized sensory nerves by inflammatory enzymes released during wound healing."
The study authors further explain that the ocular surface (epithelium and cornea) and the tear gland function as an integrated unit, and that stimulation of the sensory nerves in the ocular surface is what drives tear production and the blink response that spreads and clears tears from the ocular surface. The most striking finding in this study was the "progressive decrease in tear clearance after LASIK." Dr. Battat postulates: "The delay in tear clearance observed in these LASIK patients may result from a number of factors, including decreased blink rate caused by bilateral corneal denervation [sensory nerve amputation] and resultant increased tear film evaporation."
Finally, the study reports that the fluctuating vision reported by many of the patients in the study improved after blinking or use of preservative-free artificial tears.
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