LASIK and Dry Eye Disease: A Case Report

Background: Post- Laser- assisted in situ keratomileusis (LASIK) dry eye is one of the most common postoperative dry eyes after ophthalmic surgeries. Clinically, patients have positive vital staining of the ocular surface, decreased tear breakup times, reduced corneal sensitivity, and decreased visual acuity. In majority of patients, symptoms last about one month, but some patients can experience these symptoms for more than a year. Case presentation: A 29-year-old female with Dry Eye Disease (DED) secondary to isotretinoin use wanted to undergo LASIK for refractive improvement. Ophthalmologists were thorough in informing the patient of the significant risk of post-operative dry eyes, especially in patients with pre-operative DED. A cautious approach was taken by the ophthalmologist, and the patient's opinion and needs considered. Post-operatively, the patient continues to have DED but reports it is not worse than pre-LASIK and continues to be complaint with dry eye disease treatment. Conclusions: In patients with existing DED, clinicians are vigilant in progressing with LASIK, due to post-operative dry eye symptoms. Careful patient selection and preoperative ocular surface management is recommended for such patient groups. This case reports highlights the importance of clinicians allowing patients to come to an informed decision regarding their care. This patient-centered approach is a model of care that respects patients' experiences, values, needs and preferences, whilst improving clinical outcomes, better use of resources and increased satisfaction with care.