Corneal Refractive Surgery in Patients with History of Optic Neuritis

Abstract

PurposeThe purpose of this study was to evaluate the risk of recurrence of optic neuritis after corneal refractive surgery in patients with a history of optic neuritis and to examine the safety and efficacy of the procedure in this population.MethodsThis was a retrospective chart review of patients with a history of optic neuritis who underwent laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) at a single tertiary center from June 1996 to December 2014. Fifteen eyes of 14 patients were included in this study. Visual acuity before and after the surgery was recorded. Patients were followed-up for over five years postoperatively for the recurrence of optic neuritis.ResultsThe average LogMAR best corrected visual acuity (BCVA) preoperatively was 0.12 ± 0.19 (–0.10 to 0.60) and postoperatively was 0.06 ± 0.10 (–0.10 to 0.30). No eyes lost lines of BCVA. The average LogMAR uncorrected distance visual acuity (UDVA) after surgery was 0.12 ± 0.13 (0.00 to 0.48). Twenty-eight percent of patients reached a UDVA of 20/20 or better after refractive surgery. Optic neuritis recurred in 3/15 (20%) eyes and 3/14 patients (21%).ConclusionWhile corneal refractive procedures appear safe in patients with a history of optic neuritis, our data suggest that their efficacy may be reduced.

Laser-Assisted In Situ Keratomileusis Surgery on a Patient with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease or Neuromyelitis Optica Spectrum Disorder

“…Minor ocular trauma has been shown to trigger the onset of NMOSD and ON [ 4 ]; consequently, LASIK and PRK may carry this risk. Each attack of ON risks persistent (or permanent) loss of contrast sensitivity, color vision, and visual fields [ 3 ]. Therefore, we suggest that practitioners evaluate the baseline level of contrast sensitivity in MOGAD and NMOSD patients and utilize wavefront-guided technology [ 5 ] or customized topography laser treatments [ 6 ] that have been shown to minimize reductions in contrast sensitivity in the general population.…”

“…While MOGAD often meets the clinical criteria for NMOSD, defined as longitudinally extensive transverse myelitis, optic neuritis (ON), area postrema syndrome, and diencephalic, cerebral, or symptomatic brainstem syndromes [ 1 , 2 ], MOGAD requires MOG-Ab seropositivity for diagnosis [ 2 ]. Studies examining laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in patients with a history of MS-associated optic neuritis suggest that the procedure is safe [ 3 ]. However, little is reported about the safety and efficacy of refractive surgery in MOGAD or NMOSD patients.…”

Femtosecond‑LASIK outcomes using the VisuMax®‑MEL® 80 platform for hyperopia and hyperopic astigmatism refractive surgery

“…severe dry eye syndrome, ocular inflammation or infection) (1,3,33), patients with eye-related conditions which might interfere with visual acuity (eg. cataract, congenital or acquired macular pathology, optic nerve pathology or retinal vascular pathology) (1,(38)(39)(40)(41)(42)(43)(44), patients with previous ocular trauma or any previous ocular procedures (eg. scleral, vitreo-retinal surgery, glaucoma laser procedures or glaucoma surgery) (1,(45)(46)(47) and patients taking medication with potential ocular side effects (eg.…”