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Hello! I’ve been thinking of doing LASIK but I’m concerned that my dry eye syndrome may worsen after LASIK. I’ve been having dry eyes for some time, which have worsen due to over wearing of contact lens. Hence I’ve now switched to wearing spectacles only. I’ve read from one of your entries that the incidence of dry eyes is reportedly lower for ReLEx Smile.
Is ReLEx Smile the best option for those with dry eyes? Can I still consider LASIK as one of my options?
Suitability for Lasik / Refractive Surgery is a common concern of patients with dry eyes.
It is well established that post-Lasik, patients experience longer periods of reduced cornea sensitivity and symptomatic dry eyes.
This is thought to be related to the cornea nerves being severed at the nasal and temporal limbus during creation of the flap.
However dry eyes per se doesn’t automatically disqualify you from having Lasik performed.
This is because most patients with symptomatic dry eyes can be optimised before surgery so that they may get better results after surgery. A complete pre-surgical examination with your Ophthalmologist is recommended.
SmILE / ReLEx is a great option for patients considering Lasik, especially if they have symptomatic dry eyes.
It is postulated that the all-femtosecond procedure cleaves the lenticule within the intrastromal bed of the cornea, and hence spares a significant quantity of corneal nerves as it does not require the creation of the corneal flap.
Several case-series studies have demonstrated that:
1. Corneal sensation returns more rapidly after SmILE
2. There have been anecdotal reports of less problems with dry eyes.
As SmILE is a relatively young procedure, there are no truly objective (direct head-to-head controlled, blinded-observer) studies that have evaluated these reports.
So, to summarise that super-long answer:
1. Dry eyes does not disqualify you from having Lasik.
2. I would suggest a thorough evaluation by your Ophthalmologist as he may be further able to optimise your condition prior to having any surgery.
3. If you do choose to have Lasik surgery performed, SmILE is a great option for dry eyes as it theoretically and on several objective parameters seems to perform better for patients with dry eyes (including more rapid return of corneal sensation, and normalisation of Schirmer tear break-up times).
Hope this is helpful!
Dr E-Shawn Goh