Dry eye is one of the most common concerns patients raise when considering refractive surgery, and it is a concern that should be taken seriously, because it can materially affect both surgical suitability and postoperative quality of life.
Laser eye procedures such as LASIK and SMILE involve reshaping the cornea, which disrupts corneal nerves that regulate tear production and blink reflex. Meta-analysis data have demonstrated that a significant proportion of patients experience increased dry eye symptoms following laser surgery, particularly in the early postoperative period.¹ In patients with pre-existing dry eye disease, laser surgery can exacerbate symptoms substantially.
ICL surgery offers a specific clinical advantage in this context. Because the cornea is not reshaped, corneal nerve architecture is fully preserved. Tear film physiology is largely unaffected by the procedure.² At Blue Fin Vision®, patients with clinically significant dry eye who would otherwise be suitable for laser surgery are assessed for ICL as the preferred alternative. The optical outcome is comparable; the ocular surface impact is fundamentally different.
Lens replacement surgery also leaves the corneal surface structurally unchanged, so postoperative dry eye risk from corneal nerve disruption does not apply. However, dry eye symptoms can still occur after any intraocular surgery in patients with a compromised ocular surface, and pre-operative tear film assessment remains part of the diagnostic pathway.³
Tear film evaluation is a mandatory component of refractive diagnostics at Blue Fin Vision®, not because it is routine, but because it directly influences which procedure is safe.
References
- Kobashi H, Kamiya K, Shiratani T, Igarashi A, Ishii R, Shimizu K. Dry eye disease after photorefractive keratectomy and laser in situ keratomileusis: meta-analysis. Cornea. 2017;36(1):85–91.
- Packer M. The Implantable Collamer Lens with a central port: review of the literature. Clin Ophthalmol. 2018;12:2427–2438.
- Ambrósio R Jr, Belin MW. Imaging of the cornea: topography vs tomography. J Refract Surg. 2010;26(11):847–849.
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