It’s nearly impossible to navigate artificial tear eye drops. There are just way too many manufacturers, options and marketing terms muddying the waters. It makes it a tall order to find out what are the best eye drops after lasik. But let’s attempt to provide a map to get you to your destination
Where to start?
To some extent, you ARE going to have to listen to some of the marketing terms for artificial tears. The fact of the matter is that some artificial tear eye drops are better than others.
If you don’t want to read any further, try out something like Refresh Optive or Sustane Ultra. Those can be the best eye drop after lasik for most people.
But everyone is different, and there really is a lot to learn about this subject.
What’s In Artificial Tear Eye Drops?
All artificial tears contain certain “active ingredients". These active ingredients are the special compounds that provide lubrication. There is a list of active ingredients already approved by the FDA to allow manufacturers to develop artificial tears without having to go through a lengthy approval process - speeding up the time frame for an artificial tear to hit the market.
But also within artificial tears are “inactive ingredients". These ingredients may in fact actually contribute to the tear to do its job. These ingredients just haven't gone through the FDA-approval process. So by labeling these ingredients as inactive, the manufacturer of the artificial tear can speed up the approval of its new artificial tear design. These additional inactive ingredients can do all sorts of things such as binding extra water molecules or contributing to the oil layer of the tear film. But unless you really love chemistry, you probably aren't going to go and learn about all the different extra compounds. So at some point you have to trust the extra benefits of the inactive ingredients.
This means you can't compare artificial tears directly by looking at the active ingredients. You may find generic or store brand artificial tears that contain the same active ingredients as “name brand" artificial tear and claim to be similar. But it may not be. Because of the added inactive ingredients, the name brand artificial tear may be superior.
Despite two artificial tears looking about the same on paper, one may be better than the other…
So again, where to start?
Well, there are a few different categories of artificial tears we can sort by:
Preservative Free Artificial Tear
Before we get into the plethora of different types of artificial tears, let's start with the most important property to look for after lasik: Preservative-free.
In normal eye drops, a preservative is added to prevent the growth of bacteria. It turns out, however, that this preservative is slightly toxic to the surface of the eye. Not an issue when using eye drops four times a day or less, but it starts to become a bigger issue when using eye drops more than that or when starting out with a sensitive eye - both of those situations apply after lasik.
For those scenarios, preservative-free eye drops exist. To get around the bacteria growing problem, these eye drops typically exist in tiny little vials. Each vial of artificial tears contains just a small volume of eye drops and is only open for a short time. Not enough time for bacteria to grow.
Vials of preservative free artificial tear eye drops
Preservative free artificial tears are what you want to look for after lasik. This is the biggest feature you want and if you go pick up any preservative free artificial tear, you'll probably do alright after lasik.
But there is much more to discover to find the BEST eye drop for after lasik.
Eye Drops Can Range From Thin To Thick
The thickness of the eye drop is the second biggest variation you will find between artificial tear eye drops.
Eye drop compounds have advanced to become thicker. The thicker the eye drop, the more the eye drop will coat and lubricate the surface of the eye. The better the eye drop can treat dry eye. Older ingredients you may see in cheaper artificial tears (such as polyvinyl alcohol) just can't keep up with the newer artificial tears.
There can be a trade off between a thicker eye drop. The thicker the eye drop, the more blurriness one may experience after putting in the eye drop and the more crustiness one may have around the eyelashes.
Thus, the major manufacturers have a complete range of eye drops in order to satisfy the preferences of everyone.
Those with mild dry eye may be completely satisfied with some of the thinner eye drops such as Refresh Plus, Blink, Soothe, or Systane. Those with bad dry eye may strongly desire thicker eye drops such as Refresh Optive, Systane Ultra or Soothe XP or some with more advanced properties (see next section). Some may even opt for a gel-based eye drop such as Refresh Celluvisc.
Recommendation after lasik
Eye drops are very individualized. You won't know which eye drop works best for you until you try it out.
- If you have a concern about dry eye after lasik, start out with the more advanced eye drops (see next section). If you find the thickness too annoying, you can drop down to a thinner eye drop until you find one that suits you well.
- Otherwise, if you don't have a large concern, start out with some of the thicker eye drops such as Refresh Optive, Sustane Ultra or Soothe XP. From there, you can either move up or down in thickness level depending on how you feel with those eye drops.
A good starting eye drop after lasik for most people; Image courtesy of Amazon.com
Bonus Features
Oh if eye drops were only so simple. But of course, things have become much more complex and advanced all thanks to the extra “inactive ingredients" that improve the artificial tear. Let's look into what these extra features provide.
Mimic Tear Film Better
The tear film on the surface of our eye actually consists of three distinct layers. The bulk of the tear film is the watery layer we most associate with tears. But sandwiching this layer is an oil layer on the surface to prevent those tears from evaporating away and a mucus layer underneath to bind this layer to the cornea.
Layers of the tear film on our cornea; image by NIH Image Gallery from Bethesda, Maryland, USA, Public domain, via Wikimedia Commons / modified from original
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Basic artificial tears mostly mimic the watery layer.
But more advanced artificial tears also contain oils to help mimic the oil layer as well and even special molecules to help the tear bind to the cornea even more. They effectively mimic our own natural tears better to last longer and treat try eye better.
These artificial tears include:
Bind Water Molecules
Beyond just mimicking our own tears, a new class of artificial tear is designed to improve upon it.
These artificial tears contain special compounds that bind onto water molecules. This allows the tear drop to hold more water onto the eye and hydrate the eye more. Great for bad cases of dry eye. This is the newest category of artificial tear eye drops and probably the most advanced types.
This category includes:
- Systane Hydration
- Refresh Relieva & Refresh Digital
- Digital being slightly more thicker than Relieva
- BioTrue Hydration
(As you can see, for the most part these eye drops are marketed towards improved hydration on the eye)
Omega-3
The oil layer of the tear film comes from tiny glands within our eyelid. For many people, the consistency of the oils in these eyelids isn't ideal. This leads to a poor oil layer and tears that evaporate and dry out too quickly.
Much of this can be from an imbalance of Omega-3 in our diet. For this reason, one very common recommendation for treating dry eye involves supplementing our diet with Omega-3 (most commonly with a fish oil pill).
But what if instead this omega-3 is applied directly to where it's needed? That is what this next category of eye drop achieves. And it does appear that artificial tears with added omega-3 do outperform standard artificial tears.
This isn't a very big category right now, just Refresh Optive Mega-3
Preservative tears combined with omega-3; Image courtesy of Amazon.com
Multidose bottle
Annoyed by the tiny vials that preservative free artificial tears come in? Then this category is for you.
Tiny vials are one way to make sure that bacteria can't grow in the artificial solution without preservatives. But special eye dropper bottles exist which allow for preservative free eye drops in a single bottle - eliminating the need for multiple vials.
Multidose bottle of preservative free tears; Image courtesy of Amazon.com
These eye dropper bottles have a special one way filter. Eye drops are able to pass out of the bottle, but nothing, such as bacteria, can pass in. You can have all the benefits of preservative free eye drops but without the need for the hassle of tiny and difficult to use vials. Great for the times when you want a larger bottle to squeeze for eye drops. (But the small vials still can be useful to pack artificial tears in your pocket or small purses).
This category includes:
Conveniently, many of the most advanced eye drops being made today also come in a multidose bottle.
Summary Of Recommendations
- Above all, choose a preservative free artificial tear eye drop after lasik. This is the most important thing to look for. You will be using artificial tears frequently and you don’t want preservatives in other artificial tear eye drops to irritate your eyes.
- If you already have dry eye or have a strong concern for dry eye, it doesn’t hurt to start with some of the more advanced eye drops such as the drops with extra hydration or omega-3.
- Otherwise, the standard but thicker artificial tear drops such as the Refresh Optive or Systane Ultra can be a good starting point until you figure out whether you need something more or less advanced.
- Stick with the name brand eye drops. They have extra “inactive" ingredients which just may allow them to work better.
- Don’t stress too much about selecting the perfect artificial tear for your eyes. There is no one perfect solution for you or anyone. Many options can work just fine.
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