Question: I am interested in LASIK but have a few concerns:
1) My vision has gotten progressively more near-sighted over the past several years. Small changes, but I started at about -2.00 in each eye in my early twenties, and now I am 28 and at -3.75. The changes seem to be slowing down, but it hasn't stopped. I heard that you should wait until vision is stable.
2) I have dry eyes. It is not usually severe, and much of the time it doesn't bother me. But, there are times when I have to use artificial tears (which don't seem to help much), and occasionally it gets pretty bad, and is extremely bothersome. I am confused about the information I've read about LASIK and dry eyes. Is the worsening of dry eye symptoms after LASIK permanent or temporary?
3) If I choose to get tear duct plugs, how much extra might that cost, and how effective are they? What are the downsides of getting them?
Answer: Your questions ascertaining your suitability for LASIK are excellent. First, if your vision has progressed from -2.00 to -3.75 during your early to late twenties it suggests that your nearsightedness is progressive rather than stable at this time. Over the past few years criteria for refractive stability have loosened up somewhat but a conservative approach might be to demonstrate that your prescription has not changed more than -.50 over a 12 month horizon. This would be a conservative approach to refractive stability and some LASIK Surgeons vary somewhat from this standard.
Regarding dry eyes, you certainly need to have a careful evaluation of yourr tear film as part of your LASIK consultation. Through this evaluation, the best LASIK Surgeons will be able to determine whether both the quality and quantity of the tear film will allow you to have the best possible results. If there is a deficiency in either it may be necessary to a) use artificial tears b) artificial tears + punctual plugs c) artificial tears + punctal plugs + Restasis prescription eye drops. Your LASIK Surgeon will want to treat ANY tear film deficiency PRIOR to your procedure. After LASIK it is very often the case that there is TRANSIENT dry eye whether or not you had a pre existing dry eye problem. Most often it is limited to less than 6 months after the LASIK Surgery procedure and will most likely treated with either punctal plugs and/or Restasis. If you should need punctal plugs the cost is usually covered by insurance. They along with Restasis are quite effective in dry eye treatment. Really there are no downsides to punctal plugs for dry eye should you require them.
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