What are my treatment options for severe dry eyes 1 month after ReLEx SMILE?

Doctor's Answers 2

The treatment of dry eyes after ReLEx SMILE, or other types of refractive surgery, is quite similar to dry eye treatment in general.

Therefore, firstly general measures would include taking regular breaks from prolonged visual work as well as avoiding cold dry environments if possible. This might include turning down the settings on air conditioners.

Beyond that, artificial tears are very helpful. If the dry eye is more severe, slightly thicker preparations that are preservative free would be preferred. These would include things like Optive Fusion, Systane Hydration, and other hyaluronate containing products. The drops should be used frequently, perhaps even every hour or so while the dryness is very bothersome. Besides these, gels such as Vidisic or Genteal are also helpful, and can be used perhaps 2-3 times a day. Being thicker, they help to maintain moisture around the eyes longer than more liquid preparations such as Tears Naturale or Refresh.

Another measure that can help to maintain a higher level of moisture around the eyes is punctal plugging. These plugs keep moisture around the eyes, and reduce the flow of tears or artificial tears away into the nose.

The above measures will be sufficient for the vast majority of post refractive surgery patients. Very occasionally, even drier eyes are seen, and some of them may be helped by preparing autologous serum (obtained from one's own blood) and using this as artificial tears. The various growth factors and natural proteins/vitamins in blood can help the corneal surface to heal in patients with more severe dry eyes.

Do consult with your doctor, to find out how your condition is, and to discuss which of these measures might be suitable for your particular case. Generally speaking, 1 month after refractive surgery is still considered quite soon after the operation, and you can expect spontaneous improvement (happening by itself) over the following few months.

Dry eye is a common and often chronic condition nowadays regardless whether one has had any laser surgery done. This is especially so when most of our days revolve around working at a computer or other electronic devices, where we tend to blink less fully and less frequently. Blinking actually helps in lubricating the surface of the eye.

A healthy tear film consists of the lipid, aqueous and mucous layers on the corneal surface. The main cause of dry eye is an imbalanced tear-flow system whereby there is decreased tear production and/or increased tear evaporation and drainage, affecting the quality of tear composition.

Common treatments for dry eye include using preservative-free artificial eyedrops and ointment. However, if dry eye still persists, it is important to address the root cause.

Additional treatments include increasing tear production with formulated medication, insertion of punctal plug to slow down tear outflow and warm compress when the underlying cause of dry eye is simply due to increased tear evaporation as a result of blocked oil glands around the lid margins.

The causes of dry eye can be multi-factorial. Hence, it is advisable to have a comprehensive eye examination with your eye doctor to identify the root and discuss available treatment options.

Read more about ReLEX SMILE surgery in this guide I've written.

Similar Questions

Is ReLEx® SMILE® the best option for dry eyes? Or can I still do LASIK?

Suitability for Lasik / Refractive Surgery is a common concern of patients with dry eyes. It is well established that post-Lasik, patients experience longer periods of reduced cornea sensitivity and symptomatic dry eyes. This is thought to be related to the cornea nerves being severed at the nasal and temporal limbus during creation of the flap. However dry eyes per se doesn’t automatically disqualify you from having Lasik performed. This is because most patients with symptomatic dry eyes can be optimised before surgery so that they may get better results after surgery.

Photo of Dr E-Shawn Goh

Answered By

Dr E-Shawn Goh

Ophthalmologist

What is visual acuity recovery like after ReLEx® SMILE®?

Under normal circumstances, visual recovery for ReLEx® SMILE® is usually quite quick in the initial period. Patients usually can recover about 75% of their vision the very next day. The remaining 25%, which includes other aspects (such as contrast and haloes), will gradually recover in the following days and weeks. We usually advise patients to be diligent with the prescribed eyedrops as they also help with the recovery and stabilisation of vision after the surgery. It would be worthwhile to check in with your friend in a few weeks.

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