Those most at risk of dry eyes after LASIK, are those who have the driest eyes before LASIK. The causes of these pre-existing dry eyes are the same as those in other people not going for LASIK.
They include long term contact lens use, and general factors including age, long hours of visual work and working in dry environments, and other eye conditions such as blepharitis.
Having said that, patients with dry eyes related to contact lens use often feel better after LASIK because they do not wear lenses afterwards and this helps reduce their dry eye problem.
A particular risk factor for post LASIK dry eye is an anti-acne medication called Accutane (Isotretinoin). Patients who are taking this medication are generally advised to wait until at least 6 months after stopping the medication before considering laser refractive surgery, because of the severe dry eye that this medication can cause. Sometimes the dry eye caused by this medication may be permanent and preclude the patient from having LASIK afterwards.
Rarely, systemic diseases like Sjogren syndrome are the cause of the dry eye. If known beforehand, these patients are generally advised not to have laser refractive surgery.
