My friend is considering Lasik

[Súil Eile]

My best friend has pretty much decided she wants laser eye surgery. I've a few friends who have had lasik over the years, with no major problems. But this friend has been diagnosed with dry eye and blepharitis. Now, the condition is so mild she hasn't noticed any symptoms but she has been told to use drops, compresses, and lid scrubs. She's still determined to get the surgery.

I'm just so worried that her syptoms could get worse. Her consultant doesn't seem the least bit worried about it. I don't want to scare her, but I don't think the risks have been clearly presented to her. Has anyone else here been in that position?

[Guest]

I think it's a real shame that (most?) Lasik surgeons would not consider mild dry eye to be something that should prevent people from having Lasik. Now maybe pre-existing dry eye wouldn't lead to psycho dry eyes like mine post-lasik IF the all of those surgeons had half a clue as to how to treat it... but from what I can tell, not all of them know how to properly treat people like us, so we are allowed to deteriorate further.

I suspect people with psycho dry eyes like me would be more likely to hit people who had some degree of dry eyes pre-lasik (Prior to lasik, my only symptoms were an inability to wear contacts as they dried my eyes out too much, and morning dryness which was completely alleviated with my am dose of antihistamine eye drops... the morning dryness was blamed by my ophthamologist on allergies, so it never occured to me that it could be dry eye). Add to the mix that my surgeon's solution to my pretty much instant onset of severe dry eye post Lasik was nothing more than preserved artificial tears as often as needed (I needed them every 10-15 minutes), and I think I was pretty much doomed.

If you can't talk your friend out of Lasik, maybe you can talk her into reading up on the DEWS report etc. so that she goes into the procedure VERY well informed as to how best to treat post-lasik dry eye if it occurs??

Is there any chance that she'd be open to coming here to read through some of our experiences? She can do a search for all of us post-refractive surgery people... at least then she will have a better chance of understanding just what severe dry eye can do to a person's quality of life, ability to work etc. After knowing THAT, then she will be able to make a truly informed decision on whether or not the risk is really worth it to her.

You mentioned that you don't want to scare her... Sometimes I think a good scare is needed to make people think twice... Good luck and keep us posted!

[Perception]

I have not been in a position (yet) to advise a friend on the matter. However, I know others that had it done prior to me with success. Yet, even though I tested out as a good candidate, and went to one of the most experienced around, I am now dealing with multiple issues. Your friend should have a full understanding of all the risks - not just dry eye. The sister site to this - http://www.lasermyeye.org/forums/ might be a good place for her to get some info and perspective.

[Súil Eile]

Thanks SAAG and Perception,

If you can't talk your friend out of Lasik, maybe you can talk her into reading up on the DEWS report etc. so that she goes into the procedure VERY well informed as to how best to treat post-lasik dry eye if it occurs??

I've sent her on that report, plus another couple of things. It's her decision at the end of the day but I wouldn't be much of a friend if I didn't give her a genuine insight into the real risks. I haven't had Lasik, but it appears plenty of people on here are post-Lasik sufferers. Before I joined this forum I had no idea how prevalent it is amongst Lasik patients, even though I've been reading up on DE for years. It's a well kept and closely guarded secret!


It is a real shame that eye clinics won't give out factual information. If I hear one more time that 'dry eye can be successfully treated with drops' I think I'll have a fit! It's one thing to gloss over the risks, but another completely to downgrade the affect of DE to a mild inconvenience.

That being said, I have numerous friends who have had very successful laser surgery...so I guess it all boils down to how much someone is willing to gamble at the end of the day.

[Rebecca Petris]

If your friend has already made up her mind (which is usually the case... in my experience, a relatively small percentage of people can actually be influenced by negative reports about it once they're "sold"), suggest that she look into PRK as an alternative.

The incidence of dry eye, and especially severe dry eye, after LASIK is far higher than with the flapless laser surgeries. The reason LASIK is so popular is more for short-term matters of convenience than for long term results or safety. LASIK is faster to perform and has faster healing. But the visual results are the same or better with wavefront PRK and the risk of dry eye is much lower.

[Súil Eile]

Thanks Rebecca. She got the all clear today, so she'll be going ahead with Lasik. The night vision issues with PRK were a bit of an issue. I'm very excited for her, I just hope it works out ok!

[Perception]

Thanks Rebecca. She got the all clear today, so she'll be going ahead with Lasik. The night vision issues with PRK were a bit of an issue. I'm very excited for her, I just hope it works out ok!

Lasik can cause night vision issues too. http://www.lasikcomplications.com/Wa..._15Apr2010.pdf

If your friend goes ahead with it, I hope her outcome is good, and does not become one of these statistics.

[Súil Eile]

Thanks Perception, me too. She's so happy with it right now.

As far as I know, night vision issues tend to be temporary with Lasik but could be permanent with PRK? Though I admit I don't know much about either!

[Rebecca Petris]

As far as I know, night vision issues tend to be temporary with Lasik but could be permanent with PRK? Though I admit I don't know much about either!

Actually that's not correct.

For LASIK specifically, persistent night vision symptoms are the 2nd most frequently occurring complication (after dry eye). Night vision issues can be caused by any type of laser surgery and the risk is primarily related to pupil size, prescription and corneal thickness.

Perhaps what your friend was told about was corneal haze, which is a complication specific to PRK. That is one of the other types of complications that can cause night vision symptoms. The risk of haze is much higher with very high prescriptions though there are surgical techniques to lessen the risk. But very high prescriptions are not better off with LASIK (in my opinion) because with high prescriptions LASIK carries increased risk of dry eye and night vision symptoms.

[Guest]

She's so happy with it right now.

So has she had it done then? If so, I really really hope it worked out the way it's "supposed" to... you know... the perfect vision, no more than minor discomfort etc. It's be nice to see someone have a good result!