Refractive surgery in systemic and autoimmune disease

Alkharashi, Majed; Bower, Kraig S.; Stark, Walter J.; Daoud, Yassine J.

doi:10.4103/0974-9233.124082

Cited by 11 publications

(3 citation statements)

References 53 publications

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“…However, some authors have observed that patients with well-controlled diabetes present good refractive outcomes [ 53 , 54 ]. The risk of complications after laser refractive surgery is related to poor glycemic control and laser refractive surgery may be safe in patients with no systemic or ocular complications [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

2018

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ObjectivesTo compare the anterior ocular segment biometry among Type 2 diabetes mellitus (DM) with no diabetic retinopathy (DR) and non-proliferative diabetic retinopathy (NPDR), and to evaluate the correlation of anterior ocular segment biometry with HbA1c level.MethodsA cross-sectional study was conducted in Hospital Universiti Sains Malaysia, Kelantan from November 2013 till May 2016 among Type 2 DM patients (DM with no DR and DM with NPDR). The patients were evaluated for anterior ocular segment biometry [central corneal thickness (CCT), anterior chamber width (ACW), angle opening distance (AOD) and anterior chamber angle (ACA)] by using Anterior Segment Optical Coherence Tomography (AS-OCT). Three ml venous blood was taken for the measurement of HbA1c.ResultsA total of 150 patients were included in this study (DM with no DR: 50 patients, DM with NPDR: 50 patients, non DM: 50 patients as a control group). The mean CCT and ACW showed significant difference among the three groups (p < 0.001 and p = 0.015 respectively). Based on post hoc result, there were significant mean difference of CCT between non DM and DM with NPDR (mean difference 36.14 μm, p < 0.001) and also between non DM and DM with no DR (mean difference 31.48 μm, p = 0.003). The ACW was significantly narrower in DM with NPDR (11.39 mm SD 0.62) compared to DM with no DR (11.76 mm SD 0.53) (p = 0.012). There were no significant correlation between HbA1c and all the anterior ocular segment biometry.ConclusionDiabetic patients have significantly thicker CCT regardless of retinopathy status whereas ACW was significantly narrower in DM with NPDR group compared to DM with no DR. There was no significant correlations between HbA1c and all anterior ocular segment biometry in diabetic patients regardless of DR status.

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Section: Discussionmentioning

confidence: 99%

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

2018

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“…However, certain systemic diseases, such as autoimmune or connective tissue diseases, are still considered as contraindications for LASIK. The United States Food and Drug Administration (FDA) and the American Academy of Ophthalmology (AAO) have established lists of contraindications, but these recommendations are largely based on limited evidence [ 2 ]. The presence of systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren’s syndrome, or inflammatory bowel disease is considered as a relative contraindication, and therefore, patients with stable and asymptomatic conditions are still frequently excluded from LASIK surgery [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of laser in situ keratomileusis (LASIK) in patients with stable systemic disease

Saad,

Narr,

Frings

et al. 2024

Int Ophthalmol

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Purpose To evaluate the surgical outcome in terms of safety, efficacy, predictability, and retreatment rate of LASIK surgery in patients with controlled systemic diseases in comparison with healthy individuals. Methods The retrospective study included data from 1936 eyes of 976 patients with stable systemic diseases who underwent LASIK surgery between January 2016 and June 2019. The safety, efficacy, predictability of the surgery, and retreatment rate were evaluated in comparison with a control group comprising 1951 patients. The study was approved by the local ethics committee and adhered to the principles of the Declaration of Helsinki. Statistical analysis was performed using R team and the level of statistical significance was set at p < 0.05. Results All treatment groups demonstrated high safety and efficacy indices after LASIK surgery. Furthermore, the study arms demonstrated comparable predictability and retreatment rates to the control group in nearly all cases. Retreatment rates were significantly higher in the rheumatoid arthritis group (p = 0.03), while safety indices were significantly lower in the hay fever group compared to the control group (p = 0.004). No intra- or postoperative sight-threatening complications were documented. Conclusion Our findings suggest that selected patients with stable systemic conditions can safely undergo LASIK surgery and achieve comparable outcomes to healthy individuals. Further research is needed to better understand the treatment outcomes in this challenging patient population.

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“…While it is not clear if this risk is compounded in patients who had keratitis or ulceration prior to LASIK, the risk of future disease warrants caution. Although LASIK is safe in patients with well-controlled autoimmune conditions [33, 34] and other immune-mediated inflammatory diseases, there have been reported cases of necrotizing keratitis post-LASIK in patients with well-controlled IBD [35].…”

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confidence: 99%

Should Patients with Hidradenitis Suppurativa Undergo LASIK?

et al. 2019

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Hidradenitis suppurativa (HS) is a relatively common chronic inflammatory disease with immune dysregulation. While eye manifestations of HS are rare, a dilemma arises when these patients seek treatment for refractive errors. Although excimer laser surgery can be safely performed in patients with autoimmune and immune-mediated inflammatory disease, there are caveats. Aside from the routine laser-assisted in situ keratomileusis (LASIK) screening tests, in some instances, we recommend additional screening tests in patients with HS, such as dry eye tests, consultation with specialists regarding HS diagnosis and treatment, careful assessment of the eyelids and periorbital structures, and thorough history of past and current lesions and treatments. After these patients undergo LASIK, careful, frequent, and long-term follow-up is necessary. Any adverse event or complication should be managed immediately. Funding Research to Prevent Blindness funded the study. Hoopes Vision funded the Rapid Service Fees.

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Refractive surgery in systemic and autoimmune disease

Cited by 11 publications

References 53 publications

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

Correlation of the anterior ocular segment biometry with HbA1c level in type 2 diabetes mellitus patients

Surgical outcomes of laser in situ keratomileusis (LASIK) in patients with stable systemic disease

Should Patients with Hidradenitis Suppurativa Undergo LASIK?

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