Post-LASIK dry eye disease: A comprehensive review of management and current treatment options

Abstract

Laser-assisted in situ keratomileusis (LASIK) is a unique corneal stromal laser ablation method that uses an excimer laser to reach beneath corneal dome-shaped tissues. In contrast, surface ablation methods, such as photorefractive keratectomy, include removing epithelium and cutting off the Bowman’s layer and the stromal tissue of the anterior corneal surface. Dry eye disease (DED) is the most common complication after LASIK. DED is a typical multi-factor disorder of the tear function and ocular surface that occurs when the eyes fail to produce efficient or adequate volumes of tears to moisturize the eyes. DED influences quality of life and visual perception, as symptoms often interfere with daily activities such as reading, writing, or using video display monitors. Generally, DED brings about discomfort, symptoms of visual disturbance, focal or global tear film instability with possible harm to the ocular surface, the increased osmolarity of the tear film, and subacute inflammation of the ocular surface. Almost all patients develop a degree of dryness in the postoperative period. Detection of preoperative DED and committed examination and treatment in the preoperative period, and continuing treatments postoperatively lead to rapid healing, fewer complications, and improved visual outcomes. To improve patient comfort and surgical outcomes, early treatment is required. Therefore, in this study, we aim to comprehensively review studies on the management and current treatment options for post-LASIK DED.

Topographic and surgical risk factors for high postoperative residual astigmatism after small incision lenticule extraction in patients with different degrees of myopia: a retrospective cohort study

“…Postoperative corneal epithelial thickening could be a mechanism of early myopic regression after LASIK surgery [ 19 , 20 ]. In addition, postoperative dry eye disease caused by LASIK could damage the ocular surface and change the corneal epithelial structure [ 21 ]. In addition to epithelial proliferation, the forward shift in corneal curvature could be another etiology of early myopic regression [ 19 ].…”

Refraction and topographic risk factors for early myopic regression after small-incision lenticule extraction surgery

“…The effect of laser ablation on the cornea may trigger a wound healing process that causes proliferation of the corneal epithelium 21 . In addition, postoperative dry eye disease after LASIK can damage the ocular surface and alter the structure of the corneal epithelium 22 . In previous research, the corneal epithelium was shown to proliferate in the presence of high levels of inflammatory cytokines such as growth factor and insulin-like growth factor-1 23 , 24 , which also exist in the cornea after the LASIK procedure 25 .…”

Topographic and Surgical Risk Factors for Early Myopic Regression between Small Incision Lenticule Extraction and Laser In Situ Keratomileusis

“…It is possible that the laser ablation may induce the wound-healing process of the cornea and thereby contribute to corneal epithelium proliferation [ 22 ]. Additionally, the existence of postoperative dry eye following the LASIK surgery could impair the ocular surface and change the corneal epithelium structure [ 23 ]. In relation to the molecular pathway, corneal epithelium proliferation was observed under high-level inflammatory cytokine expression such as growth factors and insulin-like growth factor-1 [ 24 , 25 ], which were present in the cornea after the LASIK surgery [ 26 ].…”