From the Guidelines
Xiidra (lifitegrast 5% ophthalmic solution) is a recommended treatment option for dry eye disease after LASIK, as it has been shown to improve signs and symptoms of dry eye syndrome. According to the 2024 study on dry eye syndrome preferred practice pattern 1, lifitegrast was approved by the FDA for the treatment of dry eye, and published studies have demonstrated its benefit in signs and symptoms over a period of 3 months. The exact mechanism of action of lifitegrast involves blocking the interaction between lymphocyte function-associated antigen 1 (LFA-1) and its ligand intracellular adhesion molecule 1 (ICAM-1), which contributes to T-cell activation and migration to target tissues.
Some key points to consider when using Xiidra for dry eye disease after LASIK include:
- Treatment should continue for at least 12 weeks to achieve optimal results, as improvement may take several weeks
- Common side effects include temporary burning or irritation upon application
- A comprehensive approach to dry eye treatment should also include preservative-free artificial tears used frequently (4-8 times daily), punctal plugs to retain natural tears, and prescription medications like Restasis (cyclosporine) or corticosteroid drops for inflammation
- Lifestyle modifications are also important, such as maintaining proper hydration, using humidifiers, taking regular screen breaks, and avoiding smoke or direct air flow to the eyes
It's also important to note that post-LASIK dry eye can persist for months or even become chronic, necessitating regular follow-up with an eye care provider to adjust treatment as needed 1. Additionally, other treatment options such as cyclosporine and corticosteroids may be considered, as they have been shown to be effective in reducing ocular irritation symptoms and improving dry eye signs 1.
From the FDA Drug Label
Lifitegrast ophthalmic solution 5% is indicated for the treatment of the signs and symptoms of dry eye disease (DED). Instill one drop of lifitegrast ophthalmic solution twice daily (approximately 12 hours apart) into each eye using a single-dose container
Xiidra (Lifitegrast) is a treatment option for dry eye disease, including for patients who have undergone LASIK surgery. The recommended dosage is one drop twice daily, approximately 12 hours apart, into each eye. It is essential to remove contact lenses before administration and wait 15 minutes before reinserting them. 2
From the Research
Treatment Options for Dry Eye Disease after LASIK
- Dry eye disease is a common complication after LASIK surgery, with symptoms and signs that can last for several months or even years after the procedure 3.
- Various treatment options are available for dry eye disease after LASIK, including tear supplements, anti-inflammatory agents, meibomian gland dysfunction management, ointment and eye patches, punctal plugs, and autologous serum eye drops 3.
- Intense pulsed light (IPL) therapy in combination with 0.1% sodium hyaluronate and heated eye mask has been shown to improve signs and symptoms of dry eye disease after LASIK 4.
Xiidra (Lifitegrast) for Dry Eye Disease
- Lifitegrast ophthalmic solution 5% (Xiidra) is a novel small molecule integrin antagonist that has been approved for the treatment of dry eye disease 5, 6, 7.
- Xiidra works by blocking the binding of intercellular adhesion molecule 1 (ICAM-1) to lymphocyte function-associated antigen 1 (LFA-1), which inhibits the inflammatory pathways in dry eye disease 5, 7.
- Clinical trials have shown that Xiidra is effective in improving symptoms and signs of dry eye disease, including eye dryness and inferior corneal fluorescein staining scores 5, 6.
- Xiidra is generally well tolerated, with common adverse effects including eye irritation, dysgeusia, and reduced visual acuity 6.
Considerations for Patients with Dry Eye Disease after LASIK
- Patients with preoperative dry eye disease should undergo careful patient selection and preoperative ocular surface management to minimize the risk of post-LASIK dry eye disease 3.
- Patients with persistent post-LASIK dry eye disease may benefit from combination therapies, such as IPL, 0.1% sodium hyaluronate, and heated eye mask, or from treatment with Xiidra 4, 5, 6.