4 ms·

Some data here [1]: A recent clinical trial [2] by the F.D.A. suggests that the complications experienced by Mr. Ramirez are not uncommon. Nearly half of al

Some data here [1]: A recent clinical trial [2] by the F.D.A. suggests that the complications experienced by Mr. Ramirez are not uncommon. Nearly half of all people who had healthy eyes before Lasik developed visual aberrations for the first time after the procedure, the trial found. Nearly one-third developed dry eyes, a complication that can cause serious discomfort, for the first time. The authors wrote that “patients undergoing Lasik surgery should be adequately counseled about the possibility of developing new visual symptoms after surgery before undergoing this elective procedure.” [1] https://www.nytimes.com/2018/06/11/well/lasik-complications-vision.html https://www.nytimes.com/2018/06/11/well/lasik-complications-... [2] https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2587831 https://jamanetwork.com/journals/jamaophthalmology/fullartic...

foobiekr 7y ago
I wonder how people who got dry eye will age. As you age dry eye symptoms tend to increase and can be associated with recurrent corneal erosions which, aside from being painful, can get infected, which can be absolutely terrible and vision threatening in extreme cases. Dry eye is hell especially if you work at a computer. As an aside, Ocusoft Retaine drops are the best thing I’ve found for dry eye; I’ve never met anyone else with the problem who uses them but it’s like night and day.
- maxkwallace 7y ago
  Eye drops do not treat the underlying cause of dry eye (unhealthy/insufficient tears, inflammation (e.g. blepharitis), or in rare cases neuropathic pain). They are just symptom relief. For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist. If all you do is use eye drops, your dry eye will likely get worse. Eye drops bolster your tear film and help prevent desiccating stress to the eye surface, but they lack growth factors and other important compounds found in biological tears, and can even contribute to washing those away. Last, whatever you do, don't use eye drops with preservatives (e.g. benzalkonium chloride).
  - arcticfox 7y ago
    > For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist Good advice to check, of course, but my friend that has chronic dry eye from Lasik was basically told it's a lifetime of drops for her now.
    - maxkwallace 7y ago
      How many quality opinions did your friend get? I also know people with DED and from my experience not all docs understand the disease well. Obviously you know more than I do, but I'm very skeptical that there isn't more to the story than "a lifetime of drops". Also, I hope your friend has tried autologous serum drops.
      - foobiekr 7y ago
        That is a great suggestion IMHO. ASTs are pretty amazing but they're not a cure for everyone. In the case above, I'm referring to my spouse. Her entire family has this problem - dry eye, frequent / continuous corneal erosions - setting in by their mid-late thirties. These are the people who end up wearing sleeping goggles, ointment, taping their lids shut, etc. It's not a lack of tear production, it's poor corneal basement layer adhesion for some undiagnosed reason and, probably, eyelids drifting open during sleep.
        gdebel 7y ago
        Ciclosporin 2% eyedrops and/or punctum plugs may be useful. I home she'll get better eventually.
        foobiekr 7y ago
        she went way past both of those. it was not a fun time getting things compounded.
    - raverbashing 7y ago
      It might very well be "just drops", but it seems knowledge of management of dry eyes is not so widespread See this https://www.reddit.com/r/lasik/comments/cfxewr/how_to_fix_dry_eyes/eufdfbb/ https://www.reddit.com/r/lasik/comments/cfxewr/how_to_fix_dr...
mcguire 7y ago
Specifically, "Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months)." So, nearly 50% had new symptoms at 3 months.
raverbashing 7y ago
> Twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. https://www.ncbi.nlm.nih.gov/pubmed/26796443 https://www.ncbi.nlm.nih.gov/pubmed/26796443

foobiekr 7y ago

I wonder how people who got dry eye will age. As you age dry eye symptoms tend to increase and can be associated with recurrent corneal erosions which, aside from being painful, can get infected, which can be absolutely terrible and vision threatening in extreme cases. Dry eye is hell especially if you work at a computer. As an aside, Ocusoft Retaine drops are the best thing I’ve found for dry eye; I’ve never met anyone else with the problem who uses them but it’s like night and day.

maxkwallace 7y ago
Eye drops do not treat the underlying cause of dry eye (unhealthy/insufficient tears, inflammation (e.g. blepharitis), or in rare cases neuropathic pain). They are just symptom relief. For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist. If all you do is use eye drops, your dry eye will likely get worse. Eye drops bolster your tear film and help prevent desiccating stress to the eye surface, but they lack growth factors and other important compounds found in biological tears, and can even contribute to washing those away. Last, whatever you do, don't use eye drops with preservatives (e.g. benzalkonium chloride).
- arcticfox 7y ago
  > For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist Good advice to check, of course, but my friend that has chronic dry eye from Lasik was basically told it's a lifetime of drops for her now.
  - maxkwallace 7y ago
    How many quality opinions did your friend get? I also know people with DED and from my experience not all docs understand the disease well. Obviously you know more than I do, but I'm very skeptical that there isn't more to the story than "a lifetime of drops". Also, I hope your friend has tried autologous serum drops.
    - foobiekr 7y ago
      That is a great suggestion IMHO. ASTs are pretty amazing but they're not a cure for everyone. In the case above, I'm referring to my spouse. Her entire family has this problem - dry eye, frequent / continuous corneal erosions - setting in by their mid-late thirties. These are the people who end up wearing sleeping goggles, ointment, taping their lids shut, etc. It's not a lack of tear production, it's poor corneal basement layer adhesion for some undiagnosed reason and, probably, eyelids drifting open during sleep.
      - gdebel 7y ago
        Ciclosporin 2% eyedrops and/or punctum plugs may be useful. I home she'll get better eventually.
        foobiekr 7y ago
        she went way past both of those. it was not a fun time getting things compounded.
  - raverbashing 7y ago
    It might very well be "just drops", but it seems knowledge of management of dry eyes is not so widespread See this https://www.reddit.com/r/lasik/comments/cfxewr/how_to_fix_dry_eyes/eufdfbb/ https://www.reddit.com/r/lasik/comments/cfxewr/how_to_fix_dr...

mcguire 7y ago

Specifically, "Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months)." So, nearly 50% had new symptoms at 3 months.

raverbashing 7y ago

> Twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. https://www.ncbi.nlm.nih.gov/pubmed/26796443 https://www.ncbi.nlm.nih.gov/pubmed/26796443