LASIK Outcomes in Patients with Underlying Systemic Contraindications: A Preliminary Study
Received 15 April 2005; accepted 20 February 2006. published online 26 April 2006.
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.
Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain.
Correspondence and reprint requests to Rosario Cobo-Soriano, MD, PhD, C/ Marquesa Viuda de Aldama 52, ch.-10. La Moraleja, 28109, Madrid, Spain.
Manuscript no. 2005-332.
No author has a proprietary interest in any method or product mentioned.
ABSTRACT