Outcomes and complications of excimer laser surgery in patients with collagen vascular and other immune-mediated inflammatory diseases.
J Cataract Refract Surg 2018;
42:1742-1752. [PMID:
28007105 DOI:
10.1016/j.jcrs.2016.09.018]
[Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/31/2016] [Accepted: 09/23/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE
To assess refractive and visual outcomes and postoperative complications in a large number of patients with well-controlled collagen vascular and other immune-mediated inflammatory diseases.
SETTING
Optical Express, Glasgow, United Kingdom.
DESIGN
Retrospective case series.
METHODS
The files were reviewed of patients who had collagen vascular and other immune-mediated inflammatory diseases and who had excimer laser surgery between 2008 and 2015. In all cases, the disease was well controlled with no flare or symptoms for a minimum of 6 months preoperatively.
RESULTS
The study comprised 622 patients (1224 eyes) with 1 of the following underlying diseases: rheumatoid arthritis (50.6% of patients), systemic lupus erythematosus (19.5%), psoriatic arthritis (10.5%), sarcoidosis (10.0%), ankylosing spondylitis (6.4%), multiple sclerosis (1.9%), or scleroderma (1.1%). Laser in situ keratomileusis (LASIK) was performed in 1114 eyes (91.0%) and photorefractive keratectomy (PRK) in 110 eyes (9.0%). The mean follow-up was 10.9 months. The preoperative spherical equivalent ranged between -10.13 diopters (D) and +4.13 D (LASIK) and -9.50 D and +4.00 D (PRK). Postoperatively, 81.8% LASIK eyes and 82.3% PRK eyes were within ±0.50 D. The uncorrected distance visual acuity was 20/20 or better in 76.8% and 73.4%, respectively. Complications were mostly those that would be expected after excimer laser surgery in a population of patients without disease with the exception of 1 peripheral flap melt that responded to treatment with topical steroids.
CONCLUSION
Excimer laser surgery can be safely performed in patients with well-controlled collagen vascular or other immune-mediated inflammatory disease.
FINANCIAL DISCLOSURE
Dr. S.C. Schallhorn is a consultant to Abbott Medical Optics, Inc., Acufocus, Inc., and Carl Zeiss Meditec AG, and a global medical director for Optical Express. No other author has a financial or proprietary interest in any material or method mentioned.
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