Article

UV toxicity may be culprit in post-LASIK dry eye

Hypoesthesia is not the origin of post-LASIK punctuate epithelial keratopathy or the so-called dry eye syndrome. Rather, these sequelae may represent a phototoxic effect of treatment with the ultraviolet excimer laser, said Carmen Barraquer-Coll, MD.

Hypoesthesia is not the origin of post-LASIK punctuate epithelial keratopathy or the so-calleddry eye syndrome. Rather, these sequelae may represent a phototoxic effect of treatment withthe ultraviolet excimer laser, said Carmen Barraquer-Coll, MD.

"In our surgical and clinical experience we have never seen dry eye in recipients ofpenetrating or lamellar grafts or in eyes that have undergone freezing keratomileusis,epikeratophakia, planar keratomileusis, or in situ keratomileusis with and without a hinge. Norhave we found any publications on the so-called dry eye syndrome after these procedures,"observed Dr. Barraquer-Coll, head, refractive surgery department, Barraquer Clinic, Bogota,Colombia.

"Like LASIK, these are all corneal surgeries associated with nerve sectioning or tissuedenervation," Dr. Barraquer-Coll said. "Use of the excimer laser is the most obvious answer to the question of what is thedifference between LASIK and these corneal surgeries."

Dr. Barraquer-Coll hypothesized that every pulse of the laser produces an equal area ofcollateral damage. In addition, through a reaction with ambient oxygen, there is the potentialfor release of ozone.

This concept is being investigated in a prospective open label clinical trial where eyes wereallocated to undergo LASIK with a standard technique or a protected technique involvingcovering of the limbus, bulbar conjunctiva, and stromal side of the flap. A preliminaryanalysis was performed using data from a total of 143 eyes. The two surgical groups were nearlyequally represented, and they were similar with respect to gender, age, preoperative SchirmerII and tear breakup time results, defocus, and total ablation depth.

In logistic regression analysis, eyes operated on with the protected technique had anapproximately 70% lower risk of dry eye syndrome postoperatively. Females had a threefoldgreater risk than males.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
(Image credit: Ophthalmology Times) 50 years of ophthalmology: What changed the game (Part 2)
(Image credit: Ophthalmology Times) 50 years of ophthalmology: What changed the game? (Part 1)
(Image credit: Ophthalmology Times) From MIGS to gene therapy: Inder Paul Singh, MD, celebrates the past and future of glaucoma care
(Image credit: Ophthalmology Times) NeuroOp Guru: Using OCT to forecast outcomes in ethambutol optic neuropathy
(Image credit: Ophthalmology Times) Inside NYEE’s new refractive solutions center with Kira Manusis, MD
(Image credit: Ophthalmology Times) Dilsher Dhoot, MD, on the evolution of geographic atrophy therapy: where are we now?
(Image credit: Ophthalmology Times Europe) Anat Loewenstein, MD, shares insights on the real-world results of remote retinal imaging
© 2025 MJH Life Sciences

All rights reserved.