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Patients always have questions about whether LASIK surgery is safe. It generally is but there are risks and complications. Dry eye (also known as tear dysfunction syndrome, dry eye syndrome, dry eye disease) is the most common complication following LASIK surgery.
While various studies make differing conclusions, there is a consensus that most LASIK patients will suffer from dry eye in the months following surgery, some will experience it for many months and according to the US Food and Drug Administration for some patients dry eye syndrome may be permanent.
One study concluded that up to 48% of patients complain of dryness symptoms during the ﬁrst six months after surgery; soreness of the eye to touch has been reported in 6.7% of LASIK patients, and sharp pains have been reported in 8.0% of LASIK patients: Hovanesian JA, Shah SS, Maloney RK. Symptoms of dry eye and recurrent erosion syndrome after refractive surgery.J Cataract Refract Surg 2001;27:577–584.
However, another study suggested that dry eye following LASIK may not be transient but more permanent in nature: Di Pascuale MA, Liu TS, Trattler W, Tseng SC Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device. J Cataract Refract Surg. 2005 Sep;31(9):1741-9.
It is thought that LASIK causes dry eye because the procedure cuts the nerves in the cornea thereby compromising the body’s ability to normally manage the tear film that prevents healthy eyes from getting dry. Fewer nerves means less sensation in the cornea which may reduce tear production but it also reduces the rate of blinking which also contribute to dry eye.
As a result of LASIK surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This has been shown to impair driving.
According to the United States Food and Drug Administration, dry eye syndrome following LASIK may be permanent and intensive drop therapy and use of plugs or other procedures may be required to treat and manage severe dry eye syndrome.
Severe dry eye impacts a patient’s general quality of life and has been linked to increased depression and anxiety: Li M, Gong L, Sun X, Chapin WJ. Anxiety and depression in patients with dry eye syndrome. Curr Eye Res. 2011 Jan;36(1):1-7.