Lenticule may beat LASIK in the dry eye arena

[kurt]

From Eyeworld.org article Lenticule may beat LASIK in the dry eye arena:

Perhaps most importantly, he found that LASIK dry eye is a spectrum of disease states, which he divided into four categories: 1) neuropathic epitheliopathy, 2) tear fluid instability, 3) real aqueous tear deficiency due to nerve damage, 4) and neuropathic pain (phantom pain). Dr. Tuisku has found that most patients improve with respect to the first three categories of dry eye 6-12 months after LASIK. "But neuropathic pain is more complex," Dr. Tuisku said.

Regeneration of nerves can take 5 years, and the nerves regenerate differently than before, leading to what Dr. Tuisku calls "aberrant nerve fibers." "As nerve fibers grow back into the flap, they branch out," Dr. Reinstein said. "There tend to be more nerve endings than originally—double or triple nerve endings. Now a breeze of wind across the eye will feel like three times the amount of breeze, causing a sensation that the eyes are very dry."

[bakunin]

Very interesting.

In my case, i have been having pain and dry eye symptons only after 6 years post-Lasik. It could fit in the neuropathic pain case, and because my symptons are much worse than my clinical signs either. But the photophobia, TBUT tests, and the dry eye when i wake up would say i really have dry eyes. Maybe i have both.

[nitrodrops]

Very interesting.

In my case, i have been having pain and dry eye symptons only after 6 years post-Lasik. It could fit in the neuropathic pain case, and because my symptons are much worse than my clinical signs either. But the photophobia, TBUT tests, and the dry eye when i wake up would say i really have dry eyes. Maybe i have both.

Mate, i have the same symptons with you. Had Lasik in 2004, DES worsens in 2009. Now under control with 4 drops per day.

[bakunin]

Mate, i have the same symptons with you. Had Lasik in 2004, DES worsens in 2009. Now under control with 4 drops per day.

Thanks for the reply! It is always good to know people with similar problems.

But in my case the drops didn't help. I got worse (perhaps not because of the drops). Homeopathy is making my eyes feel better, and with no drops since one month ago, but still far from normal eyes.( I'm still wearing moisture chamber glasses to work, because of the AC)

Have you had photophobia? Has it gone out?

[nitrodrops]

Thanks for the reply! It is always good to know people with similar problems.

But in my case the drops didn't help. I got worse (perhaps not because of the drops). Homeopathy is making my eyes feel better, and with no drops since one month ago, but still far from normal eyes.( I'm still wearing moisture chamber glasses to work, because of the AC)

Have you had photophobia? Has it gone out?

I am using the followings to control my DES
1.) 2 x lower plugs -> helps a little
2.) 2 x Restasis, one drop in morning and one in evening -> doesnt seem to work on me anymore
3.) 2 x BionTears -> twice throughout the day @ 4-6hrs interval, finds this suits me compared to Ultra Systane, and Refresh+
4.) 4 x BioTears capsules -> highly recommend, i find my eyes less dry after switching from Theretears to BioTears capsules.
5.) Visdisc gel at night
6.) warm compress in the morning
7.) 2 litres of water everyday

initially my DES Dr was prescribing 3 x different kinds of drops, asking me to use it @ 5mins interval interval, everyday in total 16 drops, which after 1 year, i dont see any improvements, i trial and error the drops off the shelves, and found BionTears suits me most. Now using 4 drops throughout the day.

No photophobia, only a little MGD diagnosed by my DES Dr.


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