Study: Sjogrens + LASIK = ...

This one is definitely going to resonate with some of our Dry Eye Talk crowd - particularly those who suffered severe dry eye after LASIK and not too longer afterwards were diagnosed with Sjogrens. Bearing in mind that the average time to diagnosis of Sjogrens is something like 10 years, these case reports should be quite sobering - and should also raise serious questions about the views propounded in a memorable editorial in one of the major refractive surgery journals a couple of years ago supporting the relative safety of LASIK in Sjogrens patients.

Incidentally, to the general public, the title of this study sounds rather misleading. I think of "Aggravated dry eye" as meaning... I was dry and you made me worse. That's not the case here.

Aggravated Dry Eye After Laser In Situ Keratomileusis in Patients With Sjögren Syndrome.
Liang L, Zhang M, Zou W, Liu Z.
Cornea. 2008 Jan;27(1):120-123

PURPOSE:: To report 2 patients with Sjögren syndrome (SS) who had no or mild dry eye symptoms preoperatively but developed severe and refractory dry eye after laser in situ keratomileusis (LASIK). METHODS:: Two women with well-controlled early-stage SS developed severe dry eye, punctate epithelial keratopathy, and refractive regression 15 and 2 months after LASIK. Both patients were treated with punctal occlusions, artificial tears, fluorometholone 0.02% eyedrops, autologous serum, and systemic immunosuppressants. RESULTS:: Ten months after treatment, both patients exhibited only minor improvements in dry eye symptoms on the basis of changes in Schirmer test results, corneal fluorescein staining, and refractive errors, whereas their tear breakup time and corneal sensation remained unchanged. CONCLUSIONS:: Severe and refractory dry eye can develop after LASIK in patients with preexisting well-controlled early-stage SS.