Dry eye surgery: laser, cost and more


Your doctor may recommend one of the many dry eye surgeries if the other treatment options don’t work for you. Although these procedures are minimally invasive, they can cause side effects.

One-off caps

A tear plug is a barrier in the tear duct that partially or completely prevents your natural tears from draining from your eyes. It helps keep your eyes hydrated.

There are two types of tear plugs:

  • Temporary one-off plugs. These are made from collagen or some other material that the body dissolves and absorbs within days to months. A doctor may recommend this option so that you can test it or undergo surgery like LASIK.
  • Semi-permanent caps. These are often made from silicone or acrylic. They can last for years. A doctor can remove them later if necessary.

Both types of plugs are inserted into tear points, which are small openings where tears naturally flow from your eyes. Semi-permanent plugs are sometimes inserted lower down in a part of the tear duct called the canaliculus.

Insertion of punctal plugs is a non-invasive procedure. Your doctor may or may not provide local anesthesia to numb the area.

You may feel pressure when the devices are inserted. Most people can return to their normal activities immediately.

You may notice an itching or itching sensation near where your doctor inserted the plugs. Most people get used to this feeling.

Other, more rare problems can include:

  • the plug that comes out or that moves
  • improper fit, which can cause the plug to rub against your eye
  • increased risk of infection
  • tearing
  • irritation of the tear ducts

Thermal cautery

Thermal cautery is a minimally invasive surgery where your doctor uses heat to close your tear ducts and prevent moisture loss. It is generally recommended if the point plugs do not work.

Your practitioner may cauterize the opening of your tear ducts permanently. Or the tear stitches can be superficially cauterized, so they are easy to reopen in the future.

The area will be numb during the procedure. This is done in your doctor’s office and usually takes a few minutes.

Avoid touching or rubbing your eyes after the procedure. Your doctor will likely prescribe antibiotics to prevent infection.

Intense pulsed light therapy

Meibomian gland dysfunction (MGD) is a common cause of dry eyes. People with this disease produce abnormal meibum. This oily substance prevents tears from evaporating from the eyes.

A Review of studies 2015 concluded that Intense Pulsed Light Therapy (IPL) can effectively treat dry eyes in people with MGD.

IPL therapy is a non-invasive procedure that is often used to treat skin conditions such as rosacea.

Light pulses are used to selectively destroy the vascular structures of the eyelid. It can help reduce inflammation and improve the function of the meibomian glands.

Before undergoing this procedure, a protective gel will be spread around your eyes and you will put on protective goggles. Your doctor will then use a device to send flashes of light into the skin around your eye.

You will apply a special sunscreen to the treated areas for 48 hours after the IPL treatment. You may need four separate follow-up sessions for the most effective treatment.

Laser surgery

Laser-assisted keratomileusis in situ (LASIK) surgery to correct your vision often causes temporary dry eyes. It can also improve pre-existing dry eyes.

According to the American Refractive Surgery Council, approximately 60 percent of people in an FDA study who reported dry eyes before LASIK said they noticed improvements after the procedure.

Since LASIK surgery usually makes the eyes dry while they heal, your doctor may recommend that you insert temporary tear plugs or use other dry eye treatments.

Minor salivary gland autologous transplant

Severe dry eye syndrome is sometimes linked to rare disorders, such as Stevens-Johnson syndrome or pemphigoid of the scarred lining of the eye.

Drugs and most surgeries do not correct dry eye in people with these conditions. This can eventually cause blindness.

If you have severe, untreatable dry eyes, your doctor may recommend a minor salivary autologous transplant. This relatively new procedure involves implanting a salivary gland in place of your tear duct to keep your eyes hydrated.

A 2017 study found that this treatment option effectively treated dry eye. Talk to your doctor if you want to know more.

Amniotic membrane

The amniotic membrane (AM) is another option for people with keratitis that is not manageable with other treatments. Keratitis is a lesion of the surface of the eye caused by dryness.

AM protects the eye by acting as a physical barrier. It is also believed to have antimicrobial properties.

The procedure involves implanting AM on the surface of the eye. The tissue is harvested during elective cesarean sections, screened for disease, and treated with antibiotics.

This technique previously involved surgery to implant the AM. Nowadays, an increasing number of procedures are non-invasive and are performed in a doctor’s office.

There are two types of MA:

  • AM cryopreserved. Cryopreserved MAs, such as ProKera (BioTissue), are preserved and stored in a freezer. The AM is fixed with a ring or band and inserted into the eye in the same way as a contact lens.
  • AM dehydrated. Dehydrated MAs, such as AmbioDisk (IOP Ophthalmics), are dehydrated tissue that is applied to the eye in the doctor’s office, with a bandaged contact lens covering it.

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