How LASIK Causes Dry Eye

By Jeffrey Martin, MD

Published on April 14, 2010

Laser vision correction has been a very popular elective procedure for the last 15 years. When people think of laser vision correction, they typically think of LASIK. In LASIK, we have made strides in safety and accuracy. Dr. Jeffrey Martin, of Smithtown, New York in Long Island, has been performing bladeless and custom LASIK for years. Blade-free custom LASIK, or iLASIK, is the most precise way to have LASIK according to Dr. Jeff Martin. The flap that is made with LASIK is made with a laser called Intralase giving the level of precision and safety that had not been previously available. The correction is then completed using CustomVue technology. With this technology, the laser gets a custom fingerprint of your vision and uses automatic tracking and centering as well as iris registration for the most accurate results possible.

The dry eye issue with LASIK has had to do with the flap. When a flap is made in LASIK, nerve fibers to the surface of the eye are interrupted. This leads to a delay in the pathway from the eye to the brain. The brain does not sense that the surface of the eye is dry and therefore there is not a boost in tear production from the lacrimal gland. Because Intralase makes a thinner less traumatic flap, the nerve interruption is minimized.

Some patients with hormonal changes from menopause or those with certain medical conditions or certain medications linked to dry eye should not have LASIK. With others, we can treat the dry ocular surface so that it can support LASIK without a problem. Each patient needs to be individually evaluated to see if he or she is a good candidate for LASIK, or if another laser eye surgery procedure such as PRK is more appropriate.