The importance of screening for laser-assisted in situ keratomileusis operation (LASIK) before prescribing isotretinoin

Miles, Stacia; McGlathery, William; Abernathie, Brenon

doi:10.1016/j.jaad.2005.08.060

Cited by 16 publications

(11 citation statements)

References 5 publications

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“…The "conditional/unclassified" and "inaccessible/unclassifiable" categories include a variety of events for which data are insufficient or contradictory. It is noteworthy that isotretinoin can have a significant effect on the cornea and the ocular tear film [7,8]; this is of particular clinical relevance because the age distribution of patients treated with isotretinoin overlaps to a large extent with the age distribution of patients undergoing very popular corneal refractive operations.…”

Section: Discussionmentioning

confidence: 99%

Association between isotretinoin use and central retinal vein occlusion in an adolescent with minor predisposition for thrombotic incidents: a case report

et al. 2009

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IntroductionWe report an adolescent boy with minimal pre-existing risk for thromboses who suffered central retinal vein occlusion associated with isotretinoin use for acne. To the best of our knowledge, this is the first well documented case of this association.Case presentationAn otherwise healthy 17-year-old white man who was treated with systemic isotretinoin for recalcitrant acne was referred with central retinal vein occlusion in one eye. Although a detailed investigation was negative, DNA testing revealed that the patient was a heterozygous carrier of the G20210A mutation of the prothrombin gene. Despite the fact that this particular mutation is thought to represent only a minor risk factor for thromboses, it is probable that isotretinoin treatment greatly increased the risk of a vaso-occlusive incident in this patient.ConclusionIsotretinoin use may be associated with sight- and life-threatening thrombotic adverse effects even in young patients with otherwise minimal thrombophilic risk. Physicians should be aware of such potential dangers.

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Section: Discussionmentioning

confidence: 99%

Association between isotretinoin use and central retinal vein occlusion in an adolescent with minor predisposition for thrombotic incidents: a case report

et al. 2009

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“…2 Many patients who use isotretinoin are between 18 and 30 years of age, which is a population that is prone to acne and overlaps the population that will consider wearing contact lenses and/ or having laser refractive surgery to improve their vision. 3 As with any surgical procedure, refractive surgery has side effects, of which dry eye is the most common, usually lasting for a few months. 4 Because dry eye may become worse with the use of isotretinoin, it should not be started if the patient has undergone laser refractive surgery within the previous 6 months.…”

Section: Introductionmentioning

confidence: 99%

“…4 Because dry eye may become worse with the use of isotretinoin, it should not be started if the patient has undergone laser refractive surgery within the previous 6 months. 3,5 Dermatologists commonly prescribe isotretinoin; therefore, they should screen for laser refractive surgery within the previous 6 months before starting the course. Moreover, the use of isotretinoin should be stopped for at least 6 months before undergoing laser refractive surgery to decrease further ocular complications, such as corneal ulceration, infection, and loss of vision.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the use of isotretinoin should be stopped for at least 6 months before undergoing laser refractive surgery to decrease further ocular complications, such as corneal ulceration, infection, and loss of vision. 3,5 Patients who may be considering refractive surgery or wearing contact lenses should be advised before the course is started.…”

Section: Introductionmentioning

confidence: 99%

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Dermatologists’ Knowledge and Attitudes Toward Dry Eye Disease, Refractive Surgery, and Contact Lenses When Prescribing Isotretinoin in Saudi Arabia

Basheikh

AL-Attas

Alshareef

et al. 2020

OPTH

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Purpose This study assesses the knowledge and attitudes of dermatologists in Saudi Arabia with regard to dry eye disease, refractive surgery, and contact lenses when prescribing isotretinoin. Methods A total of 150 dermatologists from major cities in Saudi Arabia were included in this cross-sectional study. Data were collected through a consent interview questionnaire. Results Of the 150 dermatologists who participated, 77 (51.3%) were men. Seventy-three (48.3%) dermatologists always prescribed isotretinoin to patients and 71 (47.3%) sometimes prescribed it. One hundred forty-six (97.3%) dermatologists self-reported their awareness of the ocular side effects of the drug. One hundred twenty (80.0%) responded that it was not important to refer patients to an ophthalmologist for an eye examination before starting the isotretinoin course. Lubricant eye drops were routinely prescribed by 96% of the respondents during the isotretinoin course. Fifty (33.3%) dermatologists rarely or never asked patients about recent refractive surgery before starting the isotretinoin course. Sixty-six (44%) dermatologists rarely or never warned their patients to avoid refractive surgery for at least 6 months after the isotretinoin course is completed. One hundred ten (73.3%) dermatologists always informed their patients of contact lens intolerance as a result of isotretinoin use. Conclusion Almost all participants prescribed lubricant eye drops routinely. Most participants self-reported their knowledge regarding the ocular side effects of isotretinoin; however, more than a third did not inquire about recent refractive surgery before starting the course, and less than half did not warn patients not to undergo refractive surgery 6 months after the end of the course. This demonstrates that a significant proportion of dermatologists do not follow the appropriate practices with respect to refractive surgery when they prescribe isotretinoin. Improving the dermatologists’ awareness regarding isotretinoin prescription practice is essential with respect to laser refractive surgery to prevent ocular damage.

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“…Previous surveys have highlighted the need to routinely screen for isotretinoin use before approving LASIK and have concluded that patients should wait six months after a course of isotretinoin before having refractive eye surgery. 5 We recently surveyed the British Association of Dermatologists, and found that 65% did not know whether any of their patients had undergone LASIK while taking isotretinoin, only 30% inquired about recent or forthcoming surgery, and 89% were unaware that isotretinoin may cause ocular problems if a patient had undergone LASIK in the preceding six months.…”

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confidence: 99%

Isotretinoin as contraindication

Malik¹,

Simpson²,

Varma³

2011

BMJ

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The importance of screening for laser-assisted in situ keratomileusis operation (LASIK) before prescribing isotretinoin

Cited by 16 publications

References 5 publications

Association between isotretinoin use and central retinal vein occlusion in an adolescent with minor predisposition for thrombotic incidents: a case report

Association between isotretinoin use and central retinal vein occlusion in an adolescent with minor predisposition for thrombotic incidents: a case report

Dermatologists’ Knowledge and Attitudes Toward Dry Eye Disease, Refractive Surgery, and Contact Lenses When Prescribing Isotretinoin in Saudi Arabia

Isotretinoin as contraindication

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