Dry eye: Remember that a frequent indication for LASIK is that dry eye is making a patient intolerant to contact lenses.

Dry eye after LASIK is a topic of current interest. In essence, cutting the LASIK flap also cuts the fine nerves at the surface of the cornea. These nerves normally sense when the cornea is dry and then cause reflex tearing and blinking. These fine nerves connect to 2 major nerves at the 3 and 9 o-clock positions at the edge of the cornea. Many reports of dry eye after LASIK are from centers which use a keratome which cuts from below ("down-up"), thus cutting the nerves connecting to both major nerves.

We believe that the low incidence for dry eye problems in our patients is eplained by two factors:

1) we use keratomes which cut the cornea sideways, and not from below, thus leaving more of the sensory nerve system intact. In fact, it has been reported that the sensation of the cornea returns to normal more quickly after a "sideways" cut than after the "down-up" method.

2) We have developed a method of creating very thin flaps (average thickness 100 microns, standard deviation = 10). We have called this Lasik "Laservue Thin Flap Lasik" and have presented this technique at major international meetings.