The Dry Eye Zone

Rebecca's Blog

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Abstract: Dry eye and refractive surgery

Predictably:

1) I could live without the Restasis/plug/Intralase cheerleading, but never mind

2) I am pleased to see the first three sentences of the Conclusions stated so nicely and I just wish these could be lifted verbatim and placed in every Informed Consent form for laser surgery, with a required verbal explanation by the physician.

3) I am just as disgusted with the last sentence of the Conclusions as I always am at this kind of a conclusion. Why laser these people with pre-existing dry eye at all?

Postrefractive surgery dry eye.
Curr Opin Ophthalmol. 2008 Jul;19(4):335-41.
Quinto GG, Camacho W, Behrens A.
The Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-0005, USA.

PURPOSE OF REVIEW: To report the recently published literature on ocular surface changes after refractive surgery, as well as the outcomes of treatment modalities on postrefractive surgery dry eye.

RECENT FINDINGS: Cyclosporine, the first US Food and Drug Administration approved agent to treat the underlying pathological mechanism of chronic dry eye, has demonstrated promising results in dry eye patients. Further, there may be an additive effect of topical cyclosporine and punctal occlusion. Femtosecond lasers for corneal flaps in laser in-situ keratomileusis seem to induce fewer signs and symptoms of dry eye and may be attributed to the creation of thinner flaps.

SUMMARY: Dry eye is one of the most common complications after photorefractive keratectomy and laser in-situ keratomileusis. Keratorefractive surgery is known to cause damage to the corneal sensory nerves. Several studies have demonstrated a decrease in corneal sensation, tear secretion, and tear film stability several months after keratorefractive surgery. For patients with preoperative dry eye, the ocular surface must be treated accordingly prior to surgery.
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