Utility studies are used to quantify patient experiences and preferences regarding a disease state, and by this metric moderate-to-severe dry eye symptoms are equivalent to moderate-to-severe angina or hospital dialysis, while mild dry eye symptoms might equate with severe migraines. These symptoms, regarded as components of dry eye, range in severity, but the effects on quality of life may be significant. While patients are typically satisfied with outcomes after their procedure, side effects do occur, mainly in the form of unpleasant ocular sensations described as dryness, burning, and discomfort. LASIK involves the creation of a superficial flap of corneal epithelium and anterior stroma, which is retracted to allow for the ablation of the underlying tissue, thus correcting refractive error and improving visual acuity. Laser in-situ keratomileusis (LASIK) is a common procedure to correct refractive error, with approximately 650,000 cases performed in the US each year. Introduction: Ocular nerve injury after LASIK and evidence for persistent ocular pain Finally, the concept of genetic susceptibility to post-LASIK ocular surface pain is presented. Potential preventative and treatment options based on approaches used for other forms of persistent post-op pain and their application to LASIK patients are also discussed. This review will focus on the known epidemiology of symptoms after LASIK and discuss mechanisms of persistent post-op pain due to nerve injury that may be relevant to these patients. In susceptible patients, these neuropathological changes, including peripheral sensitization, central sensitization, and altered descending modulation, may underlie certain persistent dry eye symptoms after LASIK surgery. While it was initially believed that these symptoms were caused by ocular surface dryness, and referred to as вЂњdry eye,вЂќ it is now increasingly understood that corneal nerve damage produced by LASIK surgery resembles the pathologic neuroplasticity associated with other forms of persistent post-operative pain. Available data suggest that approximately 20-55% of patients report persistent eye symptoms (generally regarded as at least 6В months post-operation) after LASIK surgery. Despite this, the epidemiology of persistent pain and other long-term outcomes after LASIK surgery are not well understood. LASIK surgery involves cutting a corneal flap and ablating the stroma underneath, with known damage to corneal nerves. Laser in-situ keratomileusis (LASIK) is a commonly performed surgical procedure used to correct refractive error.

Parallels 2015