Post-LASIK tear dysfunction and dysesthesia

Ocul Surf. 2010 Jul;8(3):135-45. doi: 10.1016/s1542-0124(12)70224-0.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Dry Eye Syndromes / etiology
  • Dry Eye Syndromes / metabolism*
  • Dry Eye Syndromes / physiopathology
  • Humans
  • Keratomileusis, Laser In Situ*
  • Lacrimal Apparatus / physiopathology
  • Paresthesia / etiology
  • Paresthesia / metabolism*
  • Paresthesia / physiopathology
  • Postoperative Complications*
  • Risk Factors
  • Tears / metabolism*