1
|
Anitha V, Rajaraman R, Periasamy M, Ravindran M, Rangappa R, Uduman MS. Reasons for declining corneal refractive laser correction for refractive candidates in Southern India. Indian J Ophthalmol 2024; 72:118-122. [PMID: 38131581 PMCID: PMC10841811 DOI: 10.4103/ijo.ijo_1595_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/10/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To analyze the reasons for declining corneal refractive laser correction procedures in patients presenting to tertiary eye care centers in Tamil Nadu, Southern India, and review the literature. METHODS Retrospective case records of subjects presenting from January 2019 to December 2021 for refractive surgery workup were analyzed. Demographic details and refractive parameters of patients rejected for corneal refractive laser corrections (CRLC) were documented and reviewed. RESULTS A total of 2358 patients presented for refractive surgery evaluation during the study period, and out of them, 395 patients (16.8%) were not considered ideal candidates for undergoing CRLC. The common reasons for rejecting the patients were unfit topography (n = 110, 27.8%), unstable refraction over a one-year duration (n = 9, 2.27%), low corneal thickness (n = 85, 21.5%), keratoconus (n = 5, 12.9%), and other ocular and systemic disorders (n = 48, 12.1%). CONCLUSION There was a marked change in magnitude and rationalization for not performing either laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy in our study. The reasons are unfit topography, keratoconus, and systemic disorders, which were diagnosed during pre-LASIK screening workup, being the most common cause for rejecting patients for corneal refractive corrections.
Collapse
Affiliation(s)
- Venugopal Anitha
- Cornea, and Refractive Services, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Revathi Rajaraman
- Cornea and Refractive Services, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Mangala Periasamy
- Cornea and Refractive Surgery, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Meenakshi Ravindran
- Paediatric and Strabismus Services, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Ramakrishnan Rangappa
- Glaucoma Services, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Mohammed Sithiq Uduman
- BioStatistician, Aravind Eye Hospital, Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| |
Collapse
|
2
|
Alsulami R, Alzahrani S, AlQahtani B, Khayyat H, Alghamdi S. Reasons for not performing surface ablation refractive surgery in Saudi population. Saudi J Ophthalmol 2020; 34:35-39. [PMID: 33542985 PMCID: PMC7849858 DOI: 10.4103/1319-4534.301294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 01/31/2020] [Accepted: 02/25/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE: The primary goal of this study is to analyze the reasons why refractive surgery was not performed for candidates who requested the procedure among single eye-clinic visitors in Saudi Arabia. Secondarily, we aimed to determine the corneal parameters that are characteristic of Saudi population and to figure out the relationship between the magnitude of central corneal thickness and the degree of myopia. METHODS: A retrospective data was collected for all patients who presented to a single-surgeon eye clinic at King Abdul Aziz Medical City-National Guard, Saudi Arabia, seeking refractive surgery between January 2010 and December 2015. RESULTS: Unstable refraction (21.78%) followed by amblyopia with unrealistic expectations (18.75%) and high myopia (15.62%) were the most common reasons not to proceed with refractive surgery in the included sample. The mean central corneal thickness for all patients included in this study was (538 μm ± 32.6). We found no significant relationship between central corneal thickness and the degree of myopia OD [rs(178) = −0.017, P = 0.823] and OS [rs(182) = 0.016, P = 0.831] for right and left eyes, respectively. CONCLUSION: Unstable refraction followed by amblyopia with unrealistic expectations and high myopia were the leading causes not to perform refractive surgery in this study. No significant relationship can be figured out between central corneal thickness and the degree of myopia.
Collapse
Affiliation(s)
- Raed Alsulami
- Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
| | | | - Bader AlQahtani
- Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
| | - Hassan Khayyat
- Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
| | - Saeed Alghamdi
- Ministry of National Guard Health Affairs, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
| |
Collapse
|
3
|
Shilpy N, Shah Z, Singh S, Purohit D. Prevalence of Keratoconus in Refractive Surgery Cases in Western India. Middle East Afr J Ophthalmol 2020; 27:156-159. [PMID: 33488011 PMCID: PMC7813139 DOI: 10.4103/meajo.meajo_182_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 06/04/2020] [Accepted: 06/07/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose To report the prevalence of keratoconus (KCN) in patients presenting for refractive surgery in western India. METHODS A cross-sectional, observational, retrospective study performed at a tertiary eye care center. A total of 2902 cases, aged 18-40 years who presented in the refractive surgery department between January 2014 and December 2018 were included. Records of all the included cases were reviewed. Patients showing KCN pattern on topography were noted and divided into KCN and KCN suspects. Annual and overall 5-year prevalence were calculated at 95% confidence interval (CI). Demographic details of KCN and non-KCN participants were compared. RESULTS Of the 2902 cases, 25 (0.86%) had clinical KCN and 22 (0.76%) were KCN suspects. The combined 5-year prevalence of all these 47 KCN cases was 1.61% (95% CI: 1.15%-2.07%), with an annual prevalence range of 0.97%-2.43%. The mean age of non-KCN cases was 24.60 ± 4.91 years and KCN cases was 24.62 ± 5.37 years (P = 0.98). Among the KCN cases, there were more females (30; 63.83%), and the gender ratio was significantly different than non-KCN cases (P = 0.004). CONCLUSION The prevalence of KCN in refractive surgery cases was 1.61% which is higher than those found in the western population and lower than those found in the Middle East (Saudi Arabia and Iran). Furthermore, topographic examination performed during the routine screening of patients for refractive surgery can be a useful tool to diagnose new cases of KCN in asymptomatic patients.
Collapse
Affiliation(s)
- Neha Shilpy
- Department of Cornea and Refractive Surgery, C. H. Nagri Eye Hospital, Ahmedabad, Gujarat, India
| | - Zalak Shah
- Department of Refractive Surgery, C. H. Nagri Eye Hospital, Ahmedabad, Gujarat, India
| | - Shwetambari Singh
- Department of Cornea and Refractive Surgery, C. H. Nagri Eye Hospital, Ahmedabad, Gujarat, India
| | - Dipali Purohit
- Department of Ophthalmology, AMC MET Medical College, Ahmedabad, Gujarat, India
| |
Collapse
|
4
|
Outcomes of Refractive Surgery Consultations at an Academic Center: Characteristics Associated with Proceeding (or Not Proceeding) with Surgery. J Ophthalmol 2020; 2020:4354085. [PMID: 32318279 PMCID: PMC7152937 DOI: 10.1155/2020/4354085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/13/2019] [Accepted: 02/28/2020] [Indexed: 11/17/2022] Open
Abstract
Objective Refractive surgery volume has not rebounded despite economic recovery and literature describing safety, efficacy, and high patient satisfaction. We sought to examine characteristics of consultation seekers and status after consultation. Methods Charts of patients seeking refractive surgery at Johns Hopkins University from 2013 through 2016 were retrospectively reviewed for age, gender, refractive characteristics, and outcome: surgery (photorefractive keratectomy, laser in-situ keratomileusis, implantable collamer lens, or refractive lens exchange); no surgery-"lost candidate" (good candidates who were lost after consultation); noncandidates based on technological limitations or contraindications; or no surgery-possessing expectations that surgery would not meet. Associations between characteristics and status after consultation were examined. Results Twenty percent (142/712) of all patients were "lost candidates"; 57% (408/712) completed surgery. More women (56% or 401/712) sought consultation, but a greater percentage (63% or 195/311) of men completed surgery than women did (53% or 213/401) (p=0.02). Of consultation seekers, 60% were low myopes, 29% were high myopes (>6 diopters of myopic spherical equivalent), and 11% were hyperopes. Surgical patients' mean age was 34.2 ± 10.2 (standard deviation) years; for each additional year of age, patients were less likely to have surgery (p < 0.001). Hyperopes were ≥3 times more likely than myopes to have expectations not met by surgery or to be noncandidates than to have surgery (p < 0.005). Conclusions Most patients seeking refractive surgery had 6 diopters or less of myopia. About 20% of patients were lost after consultation; better counseling and follow-up of candidates may be warranted. Expectations and technology limit eligibility for many, especially hyperopes. Low surgery volume may affect training of future refractive surgeons.
Collapse
|
5
|
Z-LASIK and Trans-PRK for correction of high-grade myopia: safety, efficacy, predictability and clinical outcomes. Int Ophthalmol 2018. [DOI: 10.1007/s10792-018-0868-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
6
|
Hashmani S, Hashmani N, Kumar S, Kumar S, Dhomeja V, Razak S, Rajani H, Hanfi AN, Adhi I. Reasons for Refusing Laser-Assisted in Situ Keratomileusis in a Pakistani Population. Cureus 2017; 9:e1391. [PMID: 28775931 PMCID: PMC5526700 DOI: 10.7759/cureus.1391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To study and analyze the reasons for not performing laser-assisted in-situ keratomileusis (LASIK) surgery in Pakistan. Methods This is a retrospective observational review of the patients who presented for LASIK surgery during January 2014 to September 2016 at the Hashmanis Hospital refractive surgery facility in Karachi, Pakistan. Results A total of 6005 eyes in 3512 patients presented for LASIK surgery. Out of these, a total of 1795 eyes (29.9%) of 899 patients (25.6%) were rejected. The most common cause for not performing LASIK surgery was found to be increased risk of postoperative ectasia seen in 534 (29.75%) eyes. In 275 (15.32%) eyes, the surgery could not be performed because of affordability of procedure or unscientific apprehensions of the patient. Keratoconus was seen in 268 (14.93%) eyes. Conclusion The patients presenting for LASIK surgery need extensive screening as the large proportion of patients may have corneal structural for not performing this procedure. The cost of the procedure plays its role as does the unscientific beliefs amongst the patients.
Collapse
Affiliation(s)
| | | | - Sham Kumar
- Dow Medical College, Civil hospital karachi
| | | | | | | | | | | | | |
Collapse
|
7
|
Galvis V, Sherwin T, Tello A, Merayo J, Barrera R, Acera A. Keratoconus: an inflammatory disorder? Eye (Lond) 2015; 29:843-59. [PMID: 25931166 PMCID: PMC4506344 DOI: 10.1038/eye.2015.63] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 03/08/2015] [Indexed: 02/06/2023] Open
Abstract
Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition.
Collapse
Affiliation(s)
- V Galvis
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
- Faculty of Health Sciences, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - T Sherwin
- Faculty of Medical and Health Sciences, Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - A Tello
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
- Faculty of Health Sciences, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - J Merayo
- Instituto Oftalmologico Fernandez-Vega, Oviedo, Spain
| | - R Barrera
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
| | - A Acera
- Bioftalmik Applied Research, Derio, Spain
| |
Collapse
|
8
|
Abstract
PURPOSE The aim of this study was to evaluate exclusion criteria in screening patients for refractive surgery. METHODS Patients screened for initial refractive surgery by a single surgeon at the Cole Eye Institute (Cleveland Clinic) between 2007 and 2012 were reviewed. Exclusion criteria for patients who were not offered refractive surgery based on history and/or examination parameters were analyzed. RESULTS A total of 1067 refractive candidates were enrolled in the study. Five hundred nineteen (48.6%) were male and 548 (51.4%) were female with a mean age of 39 ± 12 (range, 17-78) years. Refractive surgery was performed in 657 (61.6%) patients, and photorefractive keratectomy was considered the best option for 106 (9.9%) patients. Four hundred ten (38.4%) of all screened patients did not have refractive surgery, and 134 of these patients (12.6%) were considered to have contraindications for laser in situ keratomileusis and photorefractive keratectomy. Among the excluded patients, 69 (51.5%) were male and 65 (48.5%) were female with a mean age of 40 ± 14 (range, 18-78) years. Abnormal corneal topography (34.3%) and low or insufficient corneal thickness (23.1%) were the most common reasons for exclusion. High myopia (10.5%) and (insipient or definite) cataract (9.7%) were also common reasons for exclusion. Other common factors for exclusion were high hyperopia (3.7%), need to wear reading glasses after surgery (3.7%), and severe dry eye unresponsive to treatment (3.7%). CONCLUSIONS Abnormal corneal topography and low, or insufficient, corneal thickness remain the most common exclusion factors for corneal refractive surgery. Factors such as cataract, too high of correction, and severe dry eye are also common reasons for exclusion of patients.
Collapse
|
9
|
Hodge C, Chan C, Sutton G. Investigation of keratoconus in an Australian refractive population. Clin Exp Ophthalmol 2014; 42:796-8. [DOI: 10.1111/ceo.12304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 02/08/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Chris Hodge
- Vision Eye Institute; Chatswood Sydney New South Wales Australia
- Save Sight Institute; Discipline of Ophthalmology; Sydney Medical School; University of Sydney; Darlington Sydney New South Wales Australia
| | - Colin Chan
- Vision Eye Institute; Chatswood Sydney New South Wales Australia
- Faculty of Science; University of New South Wales; Sydney New South Wales Australia
| | - Gerard Sutton
- Vision Eye Institute; Chatswood Sydney New South Wales Australia
- Save Sight Institute; Discipline of Ophthalmology; Sydney Medical School; University of Sydney; Darlington Sydney New South Wales Australia
| |
Collapse
|
10
|
Bamashmus MA, Al-Salahim SA, Tarish NA, Saleh MF, Mahmoud HA, Elanwar MF, Awadalla MA. Posterior vitreous detachment and retinal detachment after implantation of the Visian phakic implantable collamer lens. Middle East Afr J Ophthalmol 2013; 20:327-31. [PMID: 24339683 PMCID: PMC3841951 DOI: 10.4103/0974-9233.120019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. Materials and Methods: This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana’a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Results: Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Conclusions: Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.
Collapse
Affiliation(s)
- Mahfouth A Bamashmus
- Eye Department, Sana'a University, Sana'a, Republic of Yemen, Cairo, Egypt ; Refractive Surgery Unit, Republic of Yemen, Cairo, Egypt
| | | | | | | | | | | | | |
Collapse
|
11
|
Sutton G, Lawless M, Hodge C. Laser in situ keratomileusis in 2012: a review. Clin Exp Optom 2013; 97:18-29. [PMID: 23786377 DOI: 10.1111/cxo.12075] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 11/08/2012] [Accepted: 12/14/2012] [Indexed: 11/25/2022] Open
Abstract
Laser in situ keratomileusis (LASIK) is a safe and effective treatment for refractive error. A combination of technological advances and increasing surgeon experience has served to further refine refractive outcomes and reduce complication rates. In this article, we review LASIK as it stands in late 2012: the procedure, indications, technology, complications and refractive outcomes.
Collapse
Affiliation(s)
- Gerard Sutton
- Vision Eye Institute, Chatswood, New South Wales, Australia; Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
| | | | | |
Collapse
|
12
|
Bamashmus MA, Mohamed AA, Alakhlee HA. A retrospective analysis of the first Yemeni experience on Artisan phakic intraocular lens for the treatment of moderate and high myopia. Oman J Ophthalmol 2013; 5:175-80. [PMID: 23439933 PMCID: PMC3574514 DOI: 10.4103/0974-620x.106098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate the outcome and safety of the iris-fixated Artisan phakic intraocular lens (PIOL) for the correction of moderate and high myopia. MATERIALS AND METHODS A retrospective non-controlled clinical study of the data of patients who underwent Artisan PIOLs between March 2006 and July 2008 was evaluated. Pre-operative examination included age, gender, refraction, uncorrected (UCVA) and best spectacle corrected (BSCVA) visual acuity, predictability and safety were analyzed. Post-operative time course ranged from 12 to 36 months. RESULTS An Artisan myopia lens was implanted in 62 eyes of 39 patients. The mean pre-operative spherical equivalent (SE) was -13.17 ± 5.62 D. The pre-operative myopia ranged from -4.5 to -24 D. Mean patient age was 25.44 ± 5.22 years. At last follow-up visit, residual SE was within ±1.00 D in 36 eyes (58.1%) and ±2.00 D in 56 eyes (90.3%). In the last visit UCVA was equal to or better than pre-operative BSCVA in 57 (91.9%) of the eyes. One eye (1.6%) lost one Snellen line, three eyes (4.8%) lost two or more Snellen lines and one eye lost vision (1.6%). Post-operative complications included anterior chamber reaction in one eye, rise in intraocular pressure in two eyes and retinal detachment in one eye. CONCLUSION When laser keratorefractive surgery is not an option, implantation of Artisan PIOL to correct moderate to high myopia results in a stable and good refractive result with few complications that must be kept in mind.
Collapse
Affiliation(s)
- Mahfouth A Bamashmus
- Department of Eye, Faculty of Medicine and Health Sciences, Sana'a University, Republic of Yemen ; Refractive Surgery Unit, Magrabi Eye Hospital, Sana'a, Republic of Yemen
| | | | | |
Collapse
|
13
|
Xu K, McKee HD, Jhanji V. Changing perspective of reasons for not performing laser-assisted in situ keratomileusis among candidates in a university eye clinic. Clin Exp Optom 2012; 96:20-4. [PMID: 22607021 DOI: 10.1111/j.1444-0938.2012.00730.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim was to retrospectively analyse the reasons for not performing laser-assisted in situ keratomileusis (LASIK) surgery among refractive surgery candidates at a university eye clinic. METHODS Case records of patients who presented to a university eye clinic between June 2005 and June 2010 for consideration for LASIK surgery were examined. Cases that did not undergo LASIK were selected for analysis. Reasons for not performing surgery in these cases were analysed. RESULTS In total, 552 patients requested LASIK between July 2005 and June 2010 and 377 (68.3 per cent) of them received refractive surgery. Among 175 (31.7 per cent) patients who did not get LASIK, 62 (35.4 per cent) were male and 113 (64.6 per cent) were female, with a mean age at presentation of 36.4 ± 9.3 years (range: 19 to 78 years). The most common reasons for not offering LASIK were low corneal thickness (28.6 per cent), high myopia (15.4 per cent), large pupil (8.0 per cent) and keratoconus (7.4 per cent). Overall, 39 patients (22.3 per cent) changed their mind after their initial consultations with surgeons. The prevalence of rejection of LASIK decreased from 44.1 per cent between July 2005 and June 2006 to 3.5 per cent between July 2009 and June 2010. CONCLUSIONS Reasons for not performing refractive surgery are quite diverse. Inadequate corneal thickness and change of mind after initial consultation were the most common reasons in the present study. There was a marked change in magnitude and trend of reasons for not performing LASIK over the study period. Further studies from settings other than university hospitals would be beneficial to compare the trend in patient selection.
Collapse
Affiliation(s)
- Kunyong Xu
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | | |
Collapse
|