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LASIK outcomes in patients with underlying systemic contraindications: a preliminary study.

Abstract：

OBJECTIVES:To determine the anatomic and functional outcomes of photorefractive surgery in patients with underlying systemic diseases that are traditionally listed as relative or absolute contraindications. DESIGN:Observational retrospective case-control study. PARTICIPANTS:The case groups were composed of 275 eyes of 141 consecutive patients who underwent a LASIK procedure with any of the following underlying conditions: autoimmune connective-tissue disorders (n = 62), psoriasis (n = 91), intestinal inflammatory diseases (n = 67), diabetes mellitus (n = 44), and history of keloid formation (n = 18). Twenty-nine patients (56 eyes) were receiving systemic immunosuppressive therapy. The control group comprised 358 eyes of 181 patients without the above-mentioned conditions who underwent LASIK. METHODS:The study had 2 parts, relating to the anatomic and functional (visual and refractive) outcomes. For anatomic outcome, we compared the entire sample of both groups. For functional outcome, only myopic eyes of each group were compared. Independent comparisons were performed between each disease group and the control group. MAIN OUTCOME MEASURES:Anatomic outcomes included perioperative and postoperative epithelial, flap, and interface complications. Functional outcomes were evaluated using visual and refractive indicators, percentage of eyes undergoing enhancement, and number of postoperative visits. RESULTS:Mild anatomic complications were observed in the case and control groups with similar percentages, and there were no statistical differences between groups. Regarding functional outcome, the only significant finding was a worse refractive outcome in the collagen vascular diseases group compared with controls. There were no other statistical differences detected in the other systemic disease groups. CONCLUSIONS:In our experience, LASIK can be performed effectively and safely in selected patients with stable and controlled systemic diseases with favorable postoperative anatomic and visual outcomes. The absolute exclusion of certain systemic contraindications should be reconsidered.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Cobo-Soriano R,Beltrán J,Baviera J

doi

10.1016/j.ophtha.2006.02.023

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

1118.e1-8

issue

7

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(06)00282-X

journal_volume

113

pub_type

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