Keratectasia following laser in situ keratomileusis in a low-risk patient with benign joint hypermobility syndrome

Galperín, Gustavo; Berra, Martín; Berra, Alejandro

doi:10.5935/0004-2749.20140030

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…Indeed, EDS is considered a contraindication to LASIK given the collagen abnormality and reported incidence of keratoconus or keratoglobus in certain subtypes. Iatrogenic keratoectasia has been reported in a patient with benign joint hypermobility syndrome (Galperin, Berra, & Berra, ).…”

Section: Discussionmentioning

confidence: 99%

Survey of Ehlers‒Danlos Patients’ ophthalmic surgery experiences

Louie

Meyerle

Francomano

et al. 2020

Molec Gen & Gen Med

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Background: Ehlers-Danlos Syndrome (EDS) is a rare disease affecting approximately 1 in 5,000 people. Although ophthalmic conditions associated with EDS have been described, little data exist concerning ophthalmic surgical outcomes experienced by EDS patients. Methods: Patients with EDS were surveyed via the EDS Society and asked about their ophthalmic surgical experiences including procedure, complications, and the timing with respect to receiving the EDS diagnosis. Complications were confirmed as such by subspecialists. Results: Of 579 respondents, 467 reported confirmed EDS, and 112 of those had an ophthalmic procedure, including refractive surgery, cataract/lens surgery, retinal surgery, strabismus surgery, oculoplastic surgery, corneal surgery, and laser surgery for glaucoma. The rate of confirmed complications was: 23%-refractive, 33%-lens/ cataract, 33%-retina, 59%-strabismus, 23%-oculoplastics, 0%-cornea, and 25%-glaucoma laser. In addition, 76% of patients underwent surgery prior to the EDS diagnosis. Conclusions: Patients with EDS may have elevated risk of postoperative ophthalmic surgical complications. It would seem reasonable to systemically and prospectively explore how patients with EDS respond to ophthalmic surgery. Furthermore, it would seem circumspect to ask surgical candidates patients about whether they carry a diagnosis of EDS or have signs and symptoms of EDS prior to surgery.

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Section: Discussionmentioning

confidence: 99%

Survey of Ehlers‒Danlos Patients’ ophthalmic surgery experiences

Louie

Meyerle

Francomano

et al. 2020

Molec Gen & Gen Med

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“…10 However, there has only been 1 case report of corneal ectasia after LASIK in a patient with benign joint hypermobility syndrome. 17 Two patients with EDS self-reported corneal ectasia after LASIK in a survey study, but this is difficult to confirm without Scheimpflug imaging. 16 The only other case report of a patient with EDS who had LASIK surgery occurred in a patient with vascular EDS, and he developed myopic regression but not kerectasia.…”

Section: Discussionmentioning

confidence: 99%

“…16 Two patients reported possible corneal ectasia, although this was not definitively confirmed because of the open-ended nature of the survey. 16 Galperin et al 17 described the only reported case of corneal ectasia after LASIK surgery in a patient with benign joint hypermobility syndrome, which is considered to be the same as hypermobile EDS. Hopping et al 18 recently presented a case report of a patient diagnosed with vascular EDS 5 years after getting LASIK surgery who developed myopic regression, Saltzmann nodules, and dry eye, but not kerectasia.…”

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confidence: 99%

Outcomes and Complications in Patients With Hypermobile Ehlers–Danlos Syndrome Who Have Undergone Laser In Situ Keratomileusis Surgery

Gauthier¹,

Bower²,

Singman³

2022

Cornea

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The purpose of this study was to determine the safety and outcomes of myopic laser in situ keratomileusis (LASIK) in patients who were secondarily diagnosed with hypermobile Ehlers-Danlos syndrome (EDS). Methods:We conducted a case series study on patients with hypermobile EDS who underwent myopic LASIK surgery. Visual acuity, manifest refraction, a full dilated eye examination, biometry measurements, and Scheimpflug imaging were performed in the Wilmer outpatient clinic.Results: There were 24 eyes of 12 patients included in this study.All participants were White women with a mean age of 46.58 years (SD 8.91 years). Participants were seen at an average of 13.83 years (SD 4.3 years, range 6-21 years) after undergoing LASIK. None of the patients in the series had a diagnosis of hypermobile EDS before LASIK surgery. Overall, 92% of patients were happy they got LASIK. The uncorrected distance visual acuity was 20/20 or better in 68% of eyes, and the best-corrected visual acuity was 20/20 or better in 92% of eyes. Manifest refraction was within 1 diopter of plano in 79% of patients. Dry eye symptoms were present in 83% of patients, and 46% of eyes had either punctate epithelial erosions or decreased tear break-up time. One of the 12 patients developed corneal ectasia in both eyes.Conclusions: Patients with hypermobile EDS are generally satisfied with myopic LASIK correction, with good visual acuity outcomes and low rates of myopic regression. However, the risk of corneal ectasia may prevent laser vision correction from being a viable treatment option in these patients. Further studies are needed to make a definitive recommendation.

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