Dry Eyes and PRK

On August 30th I posted a question regarding my extreme dry eyes.  Dr. Salz was kind enough to respond and give me some great advice.  Since then, although only about 10% better with the dry eyes after trying several of the suggestions by Dr. Salz, I started to encounter another problem.  This time I was having trouble with my contacts.  I went to see my opthamologist and he said that I had an inflamation (inflammation) of the inside of the lids caused by the contacts and that I should not be wearing contacts.  He put me on Fluorometholone 0.1%.  Since then, I haven't been able to wear my glasses.  He then suggested that I talk to someone in his office regarding PRK.  He said that w/the PRK the dry eye syndrome would not be a problem b/c of the way it's done.  From what I understand, it's a more painful procedure b/c they have to scrape the top layer of the cornea and then it takes days before vision starts to improve.  Is all this accurate?  I'm back on the Rystasis until he sees me again.  They did a test and he said that I have a condition (probably from birth) which condition's name I did not catch but the nurse said that it was like having freckles in my eyes.  Could that also affect the laser surgery?  What options do I have?  I can't see well with my glasses, they bother me tremendously and my options are contacts or laser.  Can you shed some light on these issues please?  Thank you.

[John C Hagan III, MD, FACS, FAAO]

Dry eyes is one of the most common reasons to have to stop wearing contact lens. Dry can complicate LASIK surgery but doesn't completely rule it out. Restasis take minimum of 6-8 weeks to start working and can continue to get better for up to 6 months so stick with it. If you eye is very dry and produces little tears then tear duct plugs plus the Restasis would be a good choice. The tear duct plugs or painless to put in and take about a minute, no shots or injections.

PRK is much better now than i the past and with a bandage contact lens and certain eyedrops is usually not painful.

I can't comment on the freckles as that is too vague.

JCH III MD