LASIK can lead to "ocular surface dessication"

[Scout]

http://www.ncbi.nlm.nih.gov/pubmed/21537181

Curr Opin Ophthalmol. 2011 May 2. [Epub ahead of print]

MMP-9 and the perioperative management of LASIK surgery.

Sambursky R, Oʼbrien TP.

Source
aManatee Sarasota Eye Clinic and Laser Center, Sarasota, Florida, USA bUniversity of Miami Miller School of Medicine, Miami, USA cRefractive Surgery Service, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida, USA.

Abstract

PURPOSE OF REVIEW:
Hyperosmolarity is a central mechanism causing ocular surface inflammation and eye irritation in typical patients suffering from tear dysfunction. Tear composition in dry eyes, or dysfunctional tear syndrome, may destabilize the tear film and cause ocular surface epithelial disease. Increased activity of matrix metalloproteinases (MMPs), especially MMP-9, plays a critical role in wound healing and inflammation and is primarily responsible for the pathologic alterations to the ocular surface that leads to a dysfunctional tear state.

RECENT FINDINGS:
Altered corneal epithelial barrier function is the cause for ocular irritation and visual morbidity in dry eye disease. The increased MMP-9 activity in dry eyes may contribute to deranged corneal epithelial barrier function, increased corneal epithelial desquamation, and corneal surface irregularity.

SUMMARY:
Dry eye is one of the most common complications of photorefractive keratectomy and laser in-situ keratomileusis (LASIK). LASIK has both a neurotrophic effect on the cornea and leads to a physical change in corneal shape that results in a change in tear dynamics, leading to ocular surface desiccation. The reduction in tear function after LASIK may induce an increase in osmolarity and consequently raise the concentration of proinflammatory cytokines and MMP-9 in the tear film, which results in dry eyes and insufficient attachment between the corneal flap and the corneal bed. Appropriate diagnosis and management of dysfunctional tear syndrome may lead to less postoperative LASIK complications.
PMID:
21537181
[PubMed - as supplied by publisher]

Added by Scout: So NOW they tell us?!

[NeedMyEyes]

Unfortunately

There is a girl out there somewhere who has heard she can live life without contacts, she can wake up in the morning and see the alarm clock clearly without her glasses, and that she will never have to wear those horrible glasses again...

There is a girl out there somewhere who will go to bed tonight with comfortable eyes for the last time in her life and she has no idea what nightmare awaits her.

And even though this paper is out there, she won't read it (and won't come to this website) until its too late....

[Guest]

There is a girl out there somewhere who has heard she can live life without contacts, she can wake up in the morning and see the alarm clock clearly without her glasses, and that she will never have to wear those horrible glasses again...

There is a girl out there somewhere who will go to bed tonight with comfortable eyes for the last time in her life and she has no idea what nightmare awaits her.

So true... and the thing that bothers me the most about this is that odds are she was not properly informed about the risks prior to surgery... on the morning of the surgery when she finally gets to see and sign the "informed consent" form, she will probably be told that the complications on that sheet, with the exception of a corneal transplant which is incredibly rare, are minor in nature, and easily treatable... she will probably be told that since she has been properly screened, and has a very skilled doctor, that she will absolutely not experience anything major... she might also be told that this surgery is such a breeze that she can go back to work the very next day, enjoying her new life without the need for glasses or contacts. If she HAS seen this site prior to surgery, or others like it, the surgeon might assure her that those people on the internet saying Lasik has caused horrible complications were either exaggerating, or were not properly screened - since SHE has been properly screened, and the doctor has done thousands and thousands of these procedures, she should forget about all of that nonsense she read on the internet. She decides that since the doctor is a medical professional, she will trust him over all of those complainers (who are probably lying,) on the internet.

And then, if she has the misfortune of finding out that what the doctor told her was untrue, and she finds herself suffering for years with severe complications of the surgery, there will be nothing she can do about it. The doctor will never admit to the dishonest way in which they presented the risks of surgery... the doctor most certainly won't apologize for the horrible effect that the surgery had on her life, and he definitely won't offer her a refund (maybe he'll spend the 4 grand on weekend trip somewhere for himself and his family? How lovely to know she's helped him with that in exchange for a nightmare for herself...)... there is no proof that the doctor told her what he did... There is absolutely nothing she will be able to do about it, other than accept this Lasik-induced daily struggle... accept the fact that spending thousands of dollars on treatments every year is a fact of this new life... accept the fact that she will never be able to earn the income she had once assumed she would since her eyes will no longer allow her to work so much... but hey, at least she can see 20/15, right? "You're doing great!" the surgeon will say!

Fortunately, human beings are resilient... they can figure out a way to be happy even when dealing with a lot of crap that never needed to be... She will eventually figure out how to just let this go and get over it... She'll learn to focus on the stuff in life that IS good, and try to ignore the rest... It's unfortunate though... none of this needed to happen...

[lizibet]

Thank you Saag for your post although it made me sob and sob and sob ............ it was like reading my own story word for word and the feeling of release that someone understands so completely is enormous. Truly the only way is to focus on the stuff in life that IS good ............ thank you again.