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LASIK surgeons discuss dry eye

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  • LASIK surgeons discuss dry eye

    Fascinating article.

    http://www.eyeworld.org/article.php?sid=3426

    One doctor said that he found that patients who had PRK didn't have more dryness than LASIK patients. Seems to go against much of what I have read.

    They talk a little bit about climate and dryness. Apparently doing LASIK in LA or Denver is easier to sell because the dry air makes contact lens wear difficult.

    "Dr. Salz: About the motivation of patients—one advantage of living in Los Angeles is that almost everybody is contact lens intolerant. It’s nice to be in a nice, smoggy, dry environment. I think we have more problems with contact lenses here than you might in New York or Florida or someplace like that. That’s one reason refractive surgery is a pleasure out here."

    At one point Dr. Maloney says that contact-lens intolerant patients do just as well post-LASIK as contact-lens tolerant patients. Later Dr. Donnenfeld says that "I think that the gold standard for patients who are at greatest risk for having post-LASIK dry eye are patients who are contact lens intolerant."

    This was a very interesting article for many reasons. The doctors discuss and seem to disagree on many of the same things that are discussed on this board, one doctor doesn't think Restasis works, another loves it; one recommends cautery, another likes silicon plugs, another uses Form-Fit. I guess it goes to show that just like many of us here know, there is no "right" treatment or answer that will work for everyone - DES affects everyone differently and until we have better treatments and more knowledge about underlying cause, a lot of therapy is trial and error.

    The doctors seem to agree that most patients' dry eye will resolve by 6 months post-LASIK. For patients that continue to have problems, the moderator asks whether to blame an underlying condition or the LASIK. Dr. Salz says "You never blame the LASIK." Dr. Donnenfeld has a much more reasonable answer: "The patient thinks the LASIK caused his or her dry eye, whether it did or not. But the bottom line is you have to approach these patients sympathetically. Maximize their therapy, do all the things that we’ve spoken about and really develop a realistic treatment plan that’s going to get them through this long-term dry-eye problem."
    Last edited by Flick; 26-Oct-2006, 09:51. Reason: typo
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