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Laser Vision Correction
Can Worsen Dry Eyes

NEW YORK (Reuters Health) - People with dry eyes can get better vision with laser eye surgery--but at the risk of making their dry eyes worse, according to researchers.

LASIK eye surgery can often correct the common vision problems of near- or far-sightedness, but there are side effects--one of them being eye dryness.

Now a new study shows that LASIK patients who have dry eyes going into surgery, while benefiting from it, may also have more-severe eye dryness after the procedure than other patients.

Dr. Ikuko Toda, of the Minamiaoyama Eye Clinic in Tokyo, Japan, and colleagues report the findings in the August issue of the Archives of Ophthalmology.

During LASIK (for laser-assisted in situ keratomileusis), a doctor attempts to clear blurry vision by removing a thin layer of tissue from the cornea in order to reshape it.

While the procedure is generally safe and often successful, it is not for everyone. And recent guidelines from the American Society of Cataract and Refractive Surgery call patients with dry eyes "less-than-ideal" candidates for LASIK because of the risk of worsening the problem.

Still, Toda's team notes in the new report, patients with dry eyes often want to try LASIK because they cannot comfortably wear contact lenses. To see how well such patients fare after LASIK, the researchers followed 290 patients who underwent the procedure, a majority of whom had "definite" or "probable" dry eye before surgery.

They found that in the year after LASIK, dry-eye patients saw as much vision improvement as the other patients did. However, their dry-eye symptoms were more severe throughout the year after surgery, according to the report.

Patients who had not had dry eyes before surgery did complain of dryness in the month afterward, but the problem was only temporary, Toda's team found.

"These data," they write, "may indicate that preoperative dry eye is a risk factor for severe postoperative dry eye."

They note that dry-eye patients who expect the problem to get better with LASIK because it will free them from contact lenses should be warned that their dry eyes may instead persist.

SOURCE: Archives of Ophthalmology 2002;120:1024-1028.


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