May 28, 2004
One practitioner’s approach to vanquishing dry eye
Eyeworld My 2004
To forestall LASIK-related dry eye, there are numerous tactics practitioners can take, . Pre-operatively for aqueous deficiency, Donnenfeld starts with a transiently preserved tear, such as Refresh (Allergan, Irvine, Calif.), TheraTears (Advanced Vision Research, Woburn, Mass.), or GenTeal (Novartis, Basel, Switzerland) four times a day. Donnenfeld’s second line therapy is to use Restasis (Allergan) twice a day.“I like to give Restasis for one month prior to surgery,”If the patient has improved he will then perform the LASIK procedure. However, if the patient has not gotten sufficient relief, Donnenfeld then adds punctal plugs to the mix.In performing the LASIK procedure itself, Donnenfeld tries to make the hinge as wide as possible.He also makes the flap as small as possible. To minimize ocular surface toxicity, he uses minimal medications, starting the anesthetic immediately prior to surgery. “I use a mild fluoroquinolone antibiotic and immediately post-operatively, 30 seconds after the procedure, will apply Refresh Liquigel (Allergan) to stabilize the ocular surface,” . Also for the first four hours following surgery, keep their eyes closed to allow the eyes to heal. Post-operatively, Donnenfeld recommends Refresh Liquigel or TheraTears Liquid Gel every two hours for the first day.After that, use a transiently preserved tear at least four times a day for the first week after surgery. If patients show signs of dry eye in the post-operative period, put in punctal plugs to stabilize the ocular surface.If the patients continue to have irritation after surgery then I go to Restasis after plugs,
Posted by mehdi khanlari at May 28, 2004 09:03 AM