Lagophtalmos and LASIK ?

[exam]

Hi all,
I am considering Myopia surgery. I have a -2,5 glass correction.
I am not an expert but I understand that the two main surgical operation are LASIK (best) and PRK. I also suffer of nocturnal lagophtalmos (sleeping with eyes open). SOmetimes it's really painfull in the morning, sometimes it's okay.

Do you think it is dangerous to have the LASIK if I suffer of lagophtalmos, I guess the eyes have to remain closed for a a while after the operation.

Any advice ?

[Rebecca Petris]

Hi all,
I am considering Myopia surgery. I have a -2,5 glass correction.
I am not an expert but I understand that the two main surgical operation are LASIK (best) and PRK. I also suffer of nocturnal lagophtalmos (sleeping with eyes open). SOmetimes it's really painfull in the morning, sometimes it's okay.

Do you think it is dangerous to have the LASIK if I suffer of lagophtalmos, I guess the eyes have to remain closed for a a while after the operation.

Any advice ?

Hi there and welcome. A few things for you to think about with this decision... bearing in mind I'm no expert, just an opinionated person.

1) You have a very low prescription that you want corrected. Personally I do not believe that -2.5 is worth all the risks of LASIK (the risks specific to the flap).
2) You clearly have already some issues from the lagophthalmos. Do you have anything to help you with this, for example, drops or ointment or a moisture goggle or mask or anything to cover your eyes at night.
3) BOTH LASIK and PRK have dry eye as a side effect (though with LASIK it happens much more frequently and can be more severe). If you have any condition that makes you susceptible to dry eye before surgery, and then you add the surgery, you are increasing your risk for problems after the surgery.

Personally I'm against those surgeries because of the potential long-term impact of complications. But I recognize that a lot of people want to get them anyway so my position would be, if you're determined to get it, do it as safely as possible. - Which to me means, no LASIK, just PRK, but also taking the best possible care to address your current lagophthalmos and making sure you have enough treatments available (local doctor who's good at dry eye, etc) after surgery just in case you have issues.

By the way after surgery they usually put a 'bandage' contact lens in to help with healing, so that would keep your surface protected even if your eyes don't close completely, but as soon as they take that lens out, the lagophthalmos could start being more of an issue. I would talk to an eye doctor who is not a potential surgeon (i.e. who has no chance of making money from you) and ask how they think lagophthalmos will impact your healing.

[Guest]

Well said Rebecca!

Believe me Exam, you don't want to end up like me - and I did not have any issues that made my eyes as painful as you describe prior to undergoing refractive surgery, but I STILL ended up with severe eye issues. I'd keep your glasses if I were you...

[Cali]

I suffered post-LASIK dry eye for 8 years – mild. But dry eye is a progressive disease and 2 months ago I awoke to cornea erosions all over my eyes. It felt like someone threw acid in my eyes.

Informed consent. Take the time to research the actual LASIK process and thoroughly understand it. That is key.

-When they cut the LASIK flap, they are severing cornea nerves
-Cornea nerves send the signals to produce the right quality/quantity of tears to coat/lubricate your eyes
-The tear film is made up of a lipid (oil), aqueous (water), mucuous (mucin) layers
-When you cut the nerves, the signals to produce the exact “recipe” for tear production (via the meibomian and lacrimal glands and goblet cells) are disrupted/altered
-NOBODY who has LASIK ever grows back 100% of their cornea nerves (density and length)

Your tear system is intricate and delicate. Take a minute to really think it through slowly and carefully. You are CUTTING NERVES. Right now you know what it is like to have dry eye in the morning after waking up, due to your lagophtalmos. But imagine that your most severe dry eye NEVER goes away throughout your entire day. That’s what chronic post-LASIK dry eye is like, you can never escape it, there is no magical pill or drop that can fix it. It is permanent for the rest of your life.

Did you read the Dr. Morris Waxler petition to take LASIK off the market? It's a bit long and has charts and graphs on it but it is a great education.

I didn't fully understand or think about the risk I was taking with my ONE PAIR OF EYES. I so wish I were you and could go back in time and choose not to have LASIK.