title: Post-LASIK tear dysfunction and dysesthesia.
abstract: Symptoms of tear dysfunction after laser in situ keratomileusis (LASIK) occur in nearly all patients and resolve in the vast majority. Although dry eye complaints are a leading cause of patient discomfort and dissatisfaction after LASIK, the symptoms are not uniform, and the disease is not a single entity. Post-LASIK tear dysfunction syndrome or dry eye is a term used to describe a spectrum of disease encompassing transient or persistent post-operative neurotrophic disease, tear instability, true aqueous tear deficiency, and neuropathic pain states. Neural changes in the cornea and neuropathic causes of ocular surface discomfort may play a separate or synergistic role in the development of symptoms in some patients. Most cases of early post-operative dry eye symptoms resolve with appropriate management, which includes optimizing ocular surface health before and after surgery. Severe symptoms or symptoms persisting after 9 months rarely respond satisfactorily to traditional treatment modalities and require aggressive management. This review covers current theories of post-LASIK dry eye disease, pathophysiology, risk factors, and management options for this disease spectrum of post-LASIK tear dysfunction and neuropathic pain.
authors: Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77098, USA. nettune@bcm.tmc.edu
authors: Gregory R
authors: GR
authors: Nettune
authors: Stephen C
authors: SC
authors: Pflugfelder
mesh_terms: D015352:Dry Eye Syndromes / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D007765:Lacrimal Apparatus / Q000503:physiopathology; D010292:Paresthesia / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D011183:Postoperative Complications; D012307:Risk Factors; D013666:Tears / Q000378:metabolism*