FACT: Dryness is Reduced Over Time After LASIK.
After healing is complete, LASIK is more comfortable with substantially less dry eye than contact lenses for most patients; it also causes less glare and a higher overall satisfaction rate. According to a large three-year study, 98% of LASIK patients who previously wore contacts were satisfied 3 years after vision correction, compared with 87% of those who had continued to wear contacts. [1]
In two FDA-sponsored studies, PROWL-1 and PROWL-2, mild dry eye was reported by about 1 in 4 patients at three months after surgery; the rate of moderate dry eye was 2% to 3%, and the rate of severe dry eye was 1% to 3%. By the six month mark, however, there was a significant reduction in dry eye symptoms. In fact, while 30% of patients noted new dry eye symptoms around 3 months, by the end of the study, nearly 60% reported decreased dry eye compared to before LASIK. [2]
Three years after LASIK, 98% of LASIK patients who previously wore contacts were satisfied…
and 99% of those who previously wore glasses were satisfied.
Glare, halo, starburst, and ghosting were less common after LASIK compared to before LASIK.
Symptoms & Satisfaction of Patient-Reported Outcomes With LASIK (PROWL) Studies
Chronic Dry-Eye Uncommon after LASIK and PRK
In 143 patients, 5.0% of PRK and 0.8% of LASIK developed chronic dry-eye after 12months follow-up
Title: On average, LASIK led to more satisfactory vision, including better nighttime vision with less glare, than contacts, as well as a lower rate of dry eye.
Article: “Three-Year Longitudinal Survey Comparing Visual Satisfaction with LASIK and Contact Lenses”
Authors: Price MO, Price DA, Bucci FA Jr, Durrie DS, Bond WI, Price FW Jr.
Précis: People who had LASIK three years prior were surveyed, and their responses were compared to similar people who had been wearing contacts for those three years. On average, LASIK led to more satisfactory vision, including better nighttime vision with less glare, than contacts, as well as a lower rate of dry eye. Three years after LASIK, 98% of LASIK patients who previously wore contacts were satisfied, and 99% of those who previously wore glasses were satisfied, compared with 87% of those who had continued to wear contacts. Importantly, the risk of a severe infection was twice as high in the contact lens wearers than those who underwent LASIK, as contact lenses pose a daily risk of infection.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/27208981
Full reference: Ophthalmology. 2016 Aug;123(8):1659-1666. Epub 2016 May 18. Three-Year Longitudinal Survey Comparing Visual Satisfaction with LASIK and Contact Lenses. Price MO, Price DA, Bucci FA Jr, Durrie DS, Bond WI, Price FW Jr. doi: 10.1016/j.ophtha.2016.04.003.
Keywords: LASIK, Dry Eye, Contact Lens, Glasses, Presbyopia
Title: PROWL-1 and PROWL-2
Authors: Malvina Eydelman, MD1; Gene Hilmantel, OD, MS1; Michelle E. Tarver, MD, PhD; Elizabeth M. Hofmeister, MD; Jeanine May, PhD; Keri Hammel, MS; Ron D. Hays, PhD; Frederick Ferris III, MD
Précis: Across the PROWL-1 and PROWL-2 FDA-sponsored studies of patient reported outcomes, 573 total participants reported their vision and dry eye experiences 3 and 6 months after LASIK. A significant percentage (around 45%) noted new dry eye symptoms at 3 months. However, these improved significantly over time, and vision and dry eye were better on average at 6 months than prior to surgery. Conversely, patients who reported they had preoperative dry eye symptoms were three times more likely to improve their symptoms after LASIK than patients were to develop new symptoms of dry eyes. Glare, halo, starburst, and ghosting were less common after LASIK compared to before, demonstrating improvement in vision quality for most patients.
Abstract: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2587831
Full reference: Eydelman M, Hilmantel G, Tarver ME, et al. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmol. 2017;135(1):13–22. doi:10.1001/jamaophthalmol.2016.4587
Keywords: LASIK, Contact Lens, Safety, Dry Eye
Title: Chronic Dry-eye was Uncommon after LASIK and PRK
Authors: Kraig S Bower, MD, Rose K Sia, MD, Denise S, Ryan, MS, Michael J Mines, MD, Darlene A Dartt, PhD
Précis: This prospective non-randomized clinical study was undertaken to evaluate manifestations of dry-eye after LASIK and after PRK. attempting to identify predictive factors of chronic dry-eye with a set criteria. 143 patients having LASIK and PRK were evaluated preoperatively and through 12 months postoperatively. 5% of PRK patients developed chronic dry-eye while only 0.8% of LASIK patients developed chronic dry-eye. Chronic dry eye was uncommon after LASIK and after PRK. however authors do note tear-film and ocular surface characteristics measured pre-operatively might be predict of chronic dry-eye development in PRK and LASIK.
Abstract: https://www.jcrsjournal.org/article/S0886-3350(15)01161-X/abstract
Full reference: https://www.jcrsjournal.org/article/S0886-3350(15)01161-X/fulltext
Keywords: LASIK, Dry Eye, PRK