Why does LASIK make MGD worse?

[jax8it]

As I come near to my one year mark post LASIK, I still can not understand why LASIK made my MGD worse. I did not know I had MGD prior to LASIK, never even heard of it. Of course my LASIK consultant and surgeon did not tell me anything, but that is another story. All the doctors I have seen after my surgery have told me I have nonobivious MGD and probably MGD dropout. Thinking back at my eye issues before LASIK, I am pretty sure I was suffering from some MGD. I could wear my contacts, but they would dry my eyes out as the day wore on. I would take them out as soon as I came home from work. Yet, my eyes were fine as soon as the contacts came out. I never ever had pain in my eyes. My eyes hurt bad now and they never did before lasik. Also, my eyes were sensitive to very sunny days before lasik. I always had to wear my sunglasses while outside. Yet the fluorescent lighting in my classroom did not bother me at all. Ugh!!! This is so frustrating.

I do not have toothpaste like meibum. The oil is clear. I do have some crust on my lashes in the morning upon awakening and some of my lashes may stick together. I may also be aqueous deficient too, some docs have diagnosed this as well.

Here is my regimen:
Warm compresses 2x/day
Gland expression 2x/day
Ocusoft lid wipes
Wear custom moisture chambers at work
Wear onion goggles at home

What I have tried in the past:
Plugs which causes more irritation
Doxy for about 2 months
Flax seed pills 3x/day
Fish oil pill 1x/day
Restasis for 3 months. I had no problems with it. I stopped per a docs instructions.

I would like to try lipiflow, but it is expensive and not a guaranteed to work...
I ordered blephosteam glasses. They should be here in a couple of weeks. I hoping these glasses will help open up my glands. My eyes feel good in a hot steamy shower.

Any help or suggestions would be greatly appreciated.
Bianca

[patientpatrick]

I too was diagnosed with MGD/Posterior Blepharitis. Never seemed to have a problem with it before Lasik, and during my consultation no one brought up anything. I have heard that Flaxseed Oil can cause prostate cancer my dry eye doc recommended Kirkland 1200mg Ententric coating and to take 4 caps per day. I just got on this regime for 2 weeks I will keep you posted.

[Phillips55]

Jax8it,
My experience with contacts pretty much mirrors yours. I wore contacts heavily for 15 years because I hated glasses. I didn't have a problem with dryness until about 2 years prior to lasik as they dried out later in the day. Like you the problems went away after I took them out. I had lasik in march 2011 and have had bone dry eyes ever since. It does not appear from the records that the lasik doc took any type of dry eye test. Anyway exactly 2 weeks ago I decided to try Lipiflow in my right eye. The lipiview system said my glands were in the 30's range output (normal is 70+) i have noticed more oil secretion in the right eye which has helped, but my eyes still dry out because I have a severe aqueous deficiency. I have no idea if the lipiflow and lipiview is quack medicine. Many people here who have tried say it increased their oil output but did not help their symptoms. If your interested I would try one eye at a time, which cost me 700 not including the exam.

[Long Time Dry Eye]

Just an FYI regarding my experience with the "LipiFlow Thermal Pulsation System": (just want to make sure we are talking about the same procedure). The cost was $1000/eye, and I am not sorry I had it done. Warm compresses and lid massage never helped me, but this procedure did. I had it done just before Thanksgiving. I actually started noticing improvement within a very few days. I no longer have to use Azasite, nor Alrex. I do use a tiny dot of Lotemax ointment every other night with a sleep eyeshield. (I like fans at night). I DO now do the warm compresses 2-3xwk..it makes sense that once the glands were cleared that I try to keep them clear. If anyone is thinking about the LipFlow procedure, make sure that the ophthalmologist is going to "express" those glands after the thermal and pulse massage are done. First part of treatment is like a "spa for the eyes", but the expression part is necessary, but not comfortable. My DES is not cured, but I am better able to seem like I am living a normal life. My favorite thing that has helped has been the foam sealed glasses that I finally got in a light adjusting transition lens. They are originally a sports sunglass that I use for wind, glare, cold air, dry air, which includes my home, large stores, movies, restaurants, etc, etc, etc : )