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Femtosecond laser inverted side cut, appropriate postop treatment can reduce LASIK dry eye symptoms
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MILAN, Italy — The combination of femtosecond laser inverted side-cut flaps, an anti-inflammatory and hypo-osmotic treatment may effectively manage LASIK neurotrophic epitheliopathy, promoting corneal nerve regeneration within a shorter period of time, according to one surgeon.
Mitchell A. Jackson, MD, explained that this form of pseudo-dry eye occurs in at least 50% of patients after LASIK and can last up to 2 years.
“Treatment is based on the [Dry Eye WorkShop] definition of dry eye as a combination of inflammation and hyperosmolarity,” Dr. Jackson said at the annual joint meeting of OSN and the Italian Society of Ophthalmology.
“I normally use topical cyclosporine, and in the induction phase, I also use steroids or NSAIDs such as Lotemax (loteprednol etabonate, Bausch + Lomb) or Bromday (bromfenac, Ista Pharmaceuticals) to reduce inflammation until the cyclosporine kicks in and works. At the same time, I treat hyperosmolarity with specific agents such as TheraTears (Advanced Vision Research),” he said.
In terms of techniques, the inverted side cut made by the IntraLase femtosecond laser (Abbott Medical Optics) minimizes corneal nerve severance, thus reducing dry eye symptoms in terms of severity and duration.
“The fewer nerves you cut, the faster the cornea recovers,” Dr. Jackson said.
Thanks to this technique, the amount and duration of treatment are reduced.
“Patients need shorter treatment, often no longer than 3 months, rather than 6 months to 1 year,” he said.