Dry Eyes After Laser Refractive Surgery: Causes, Care & Prevention

Whether you’re planning LASIK, PRK, or SMILE surgery, it’s important to understand one of the most common side effects: dry eye. Postoperative dryness can range from mild discomfort to a persistent condition that interferes with vision and quality of life.

In fact, research shows that up to 95% of patients experience dry eye symptoms immediately after LASIK, with about 40% still reporting symptoms six months later. For most, symptoms improve within a year, but proactive management before and after surgery can make a meaningful difference in outcomes.

What Causes Dry Eye After Refractive Surgery?

Laser vision correction changes the shape of your cornea to improve vision, but this process can also disturb the natural balance of your tear film. Here’s how:

• Corneal Nerve Disruption: Procedures like LASIK and PRK temporarily sever microscopic corneal nerves that signal the eye to produce tears.
• Reduced Blink Reflex: Some patients experience decreased blinking post-surgery, which increases evaporation of tears.
• Inflammation: The healing process triggers inflammation that can further destabilize the tear film.
• Surgical Techniques: LASIK involves creating a flap, which may contribute more to nerve disruption. SMILE, which uses a smaller incision, is associated with fewer dry eye symptoms.

Who’s at Higher Risk?

Certain patients are more likely to experience prolonged dry eye symptoms after refractive surgery. Risk factors include:

• Being female (especially post-menopausal)
• Age over 50
• High refractive corrections (i.e., large prescriptions)
• A history of dry eye disease (DED) before surgery
• Use of medications that reduce tear production, like antihistamines or antidepressants

That’s why it’s critical to have your ocular surface evaluated before surgery. Identifying and treating dry eye in advance improves the chances of full symptom resolution by the six-month mark.

Managing Dry Eye After Surgery: What Works

Fortunately, there are several highly effective strategies for treating dry eye symptoms following laser eye surgery. Your eye doctor may recommend a combination of therapies, depending on your symptom severity:

1. Non-Prescription and In-Office Options
   • Artificial tear drops and lubricating gels
   • Nighttime ointments to prevent tear evaporation while sleeping
   • Warm compresses and eyelid hygiene
   • Punctal plugs to block tear drainage and preserve natural moisture
   • LipiFlow or thermal pulsation therapy to restore oil layer of the tear film
2. Advanced or Prescription-Based Therapies
   • Prescription anti-inflammatory eye drops (e.g., cyclosporine or lifitegrast)
   • Autologous serum or plasma tears made from your own blood
   • Omega-3 fatty acid supplements to improve meibomian gland function
   • Lifestyle adjustments like using humidifiers, staying hydrated, and taking breaks from screens

Patients are also advised to avoid eye rubbing, wear sunglasses outdoors, and follow all post-operative instructions carefully to reduce inflammation and promote healing.

Is There an Alternative?

If you suffer from dry eye disease or have concerns about developing dry eye after LASIK or another surgery, you should know that you might have another option: vision correction surgery with the EVO Visian ICL Lens.

The EVO Visian ICL Lens (Implantable Collamer^Ⓡ Lens) is a different type of refractive procedure, and is often an option for patients at risk for dry eye or who are not candidates for LASIK and other refractive procedures. Unlike procedures that involve surgically reshaping the cornea, the EVO Visian ICL is an artificial lens that is implanted in the eye to correct common refractive errors like nearsightedness (myopia) and nearsightedness with astigmatism.

The EVO Visian ICL lens is crafted from a biocompatible material called Collamer, which works seamlessly with your eye. The EVO Visian ICL procedure does not lead to dry eye symptoms. Most patients experience significant vision improvement shortly after the procedure, which takes about 20 to 30 minutes. In fact, 99.4% of EVO patients report they would choose the procedure again. Unlike LASIK and other similar treatments, the EVO Visian ICL offers a removable option. If your prescription changes or you have new vision needs, your doctor can easily remove the lens

When to Talk to Your Surgeon

It’s normal to have dry eyes in the first few weeks after refractive surgery. But you should contact your eye doctor if:

• Symptoms worsen or don’t improve by the three- to six-month mark
• You experience persistent eye pain or burning
• Vision becomes blurry or fluctuates frequently
• You notice signs of infection like redness, discharge, or sensitivity to light

Persistent dry eye can lead to complications if left untreated, so it’s always better to seek help early.

Prevention Is Key

The best way to reduce your risk of dry eye after surgery is to treat existing dryness before your procedure and follow your doctor’s recovery plan closely. Most cases improve with time, but targeted therapy can shorten your recovery window and protect your long-term vision comfort.

FAQs on Dry Eyes After Laser Refractive Surgery