LASIK in Patients with Rheumatic Diseases

Surgically induced corneal necrotizing keratitis following LASIK in a patient with inflammatory bowel disease

“…Excluding patients with immune-based disorders such as psoriasis, IBDs, and systemic lupus erythematosus from refractive surgery is controversial. Alió et al 3 performed LASIK in 22 patients with controlled rheumatic disease, 3 of whom had IBD. No vision-threatening or unfavorable outcomes were encountered.…”

“…2 For these reasons, autoimmune diseases are generally regarded as a relative contraindication to keratorefractive procedures. However, there is controversy about candidacy for refractive procedures: Some authors have reported no severe complications or unfavorable outcomes after laser in situ keratomileusis (LASIK) in patients with autoimmune diseases, 3,4 whereas the United States Food and Drug Administration has listed autoimmune diseases as a group to be a contraindication to laser refractive surgery because of less predictable wound healing with the potential for corneal melt. 2 We describe a case of surgically induced necrotizing keratitis after LASIK in a patient who had not disclosed a previous total colectomy for recurrent active ulcerative colitis.…”

Excimer laser refractive surgery in patients with underlying autoimmune diseases

“…This procedure is not followed, even by the authors of a research article. 2 Second, many patients with systemic diseases require longterm use of corticosteroids that may cause cataracts at an earlier age than in the normal population. Intraocular lens power calculation is more difficult and unpredictable after excimer laser refractive surgery and may cause refractive surprises.…”

“…Photorefractive keratectomy is still a relative contraindication in patients with underlying autoimmune diseases. 2,3 Fourth, most patients who seek excimer laser refractive surgery are young or middle-aged; however, the corneal involvement usually occurs late in the course of the disease when the dry eye progresses. The late outcomes in these patients are not predictable.…”

Excimer laser refractive surgery in autoimmune diseases

“…In recently published studies, 3,4 LASIK was performed in patients with rheumatic or systemic diseases to determine the anatomical and functional outcomes as well as the safety of the procedure. The complication rates and refractive outcomes were comparable to those reported for LASIK in patients without these diseases.…”