Archive for July, 2011

New iFS Laser Minimizes Dry Eye from LASIK

Sunday, July 24th, 2011

Most patients appreciate the improved safety afforded by the IntraLase laser in creating the flap during the LASIK procedure. An additional benefit of the latest model of IntraLase laser is the reduction in both severity and duration of dry eyes after LASIK.
Our last blog post discussed the mechanism of dry eye production from LASIK. Dry eye symptoms result from the severing of corneal nerves during the procedure. So how can the iFS minimize dry eye? By limiting the number of severed nerves and promoting quicker healing of the cut nerve fibers.

An Oval LASIK flap with a wider hinge will help to minimize dry eyes from LASIK

Like all lasers used to create corneal flaps, the iFS has the ability to create very thin flaps which helps to limit the number of cut corneal nerves. The IFS, in addition, has a unique surgical planning dashboard and customization features not available on other lasers. Surgeons using the iFS have the capability to create oval shaped flaps with wider hinges that are just large enough to cover the dilated pupil. This insures that an unnnecessarily large number of nerve fibers are not cut thus minimizing dry eye symptoms.
In additon, the iFS has the ability to create an inverse beveled flap edge assuring near-perfect alignment of the flap. Because the two ends of the cut nerve are apposed closely to each other, the nerve has only a short distance to grow before healing back together.
Thinner smaller flaps and wider hinges minimizes the invasiveness of the LASIK procedure which in turn minimizes the severity and duration of dry eye symptoms from LASIK. Dry eyes often last several weeks after a LASIK procedure and are an almost universal side-effect. If you are concerned about dry eyes and wish to limit its severity choose thin-flap LASIK with the iFS laser. And if you live anywhere near Raleigh NC there’s only one place to get this procedure: the Laser Eye Center of Carolina.

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Why Do Patients Get Dry Eyes After LASIK?

Thursday, July 14th, 2011

The LASIK procedure may cause many patients to experience dry eye symptoms after their surgery. This is especially true if there was tendency toward dry eyes before LASIK. But why do so many patients experience dry eyes after LASIK? The first step of the LASIK procedure is the creation of a corneal flap, a thin layer of tissue under which laser pulses are applied to reshape the cornea in order to correct nearsightedness, farsightedness and astigmatism. Anatomically, when the flap is created, the very fine cornea nerves may be severed as part of the LASIK procedure. These nerves detect how wet the eye is and signal the lacrimal gland to produce tears. So, sometimes, the temporary interruption of the corneal nerve impulses can actually cause a lesser amount of tears to be produced, resulting in dry eyes after LASIK. If the Dry Eyes after LASIK are moderate or severe, your vision may actually be blurry due to the tear film instability. Because normal sensation may not be present as a result of severed corneal nerves patients may not feel the sandy, gritty sensation normally associated with dry eyes. Fortunately, virtually all dry eyes symptoms after LASIK are temporary and gradually decrease over time as the corneal nerves grow back. Most patients will have a resolution of dry eye symptoms within a few months of having their LASIK procedure. In some extreme cases, symptoms may persist for over one year. All LASIK patients will need to use lubricating drops frequently during the first few weeks after their LASIK procedure. Other measures are occasionally necessary to improve comfort and visual clarity. These include the use of oral Omega 3 supplements, punctal plugs and prescription eye drops such as Restasis. During your consultation it is important to disclose any symptoms you may have of dry eyes and to disclose any medications you are taking that might predispose you to dry eyes after your LASIK procedure. Your LASIK surgeon can then take the necessary steps to prepare you for your LASIK procedure and minimize the severity of dry eyes from LASIK. Working together with your surgeon will maximize your chances of a smooth post-operative course and allow you to obtain the best possible results from your LASIK procedure. Watch this blog for further tips on how to minimize symptoms of dry eyes after LASIK.

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LASIK Can’t “Do It All”

Sunday, July 3rd, 2011

Consider LASIK Alternatives

This Independence Day got me to thinking about patients and their desire to be independent of their eyeglasses. For patients seeking LASIK, often there is a ‘tipping point’ such as a contact lens related problem or it’s time to go in for their exam with the prospect of exam fees, contact lens fitting fees and the purchase of new glasses or contact lenses. Sometimes the patient just got back from a vacation or participated in an event where glasses got in the way. Or maybe the patient just got tired of pushing their glasses up their nose, putting in their contact lenses every morning or waking up unable to see. This is the point where they come in to see me. Often they are happy with what I tell them but a significant number are disappointed to learn that LASIK may not offer them everything they are looking for or is just not advised.

LASIK is a great procedure and has been around for a number of years. However, there remains a very specific ‘subset’ of patients for which LASIK is ideal. This subset includes patients between the ages of 18 and 40 without pre-existing dry eye problems, keratoconus or certain other eye diseases. The patient may have small amounts of farsightedness, or nearsightedness and/or astigmatism below a certain amount. Now don’t misunderstand me, almost half of my LASIK patients are not in this ideal category (usually because they are over the age of 40) but what I am saying is that patients who are not ideal may want to consider LASIK alternatives like Visian Implantable Contact Lenses, PRK or refractive lens exchange. The alternative is to accept certain compromises: an example might be the need for reading glasses.

The Laser Eye Center of Carolina offers more than just LASIK because LASIK is limited in who can benefit from the procedure and what it can offer. If you have a desire to become independent of glasses, consider all your options: not just LASIK.

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