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

Abstract

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.

Implication of Corneal Refractive Surgery in Duchenne Muscular Dystrophy

“…A lack of defined guidelines for DMD makes it challenging to determine if LASIK, PRK, or SMILE can be safely performed in this patient population. Patients should be counseled on the risks and suboptimal surgical outcomes of refractive surgery, especially given their history [ 33 ]. In persistent patients with DMD seeking corrective vision surgery, the ophthalmologist and patient should be made aware of the lack of documented outcomes and must have a detailed discussion about the relative risks of refractive surgery in this patient population.…”

Assessing Patients with Alpha-1 Antitrypsin Deficiency for Corneal Refractive Surgery: A Review and Clinical Experience

“…However, a lack of defined guidelines for AATD makes it challenging to determine if LASIK, PRK, or SMILE can be safely performed in this patient population. Patients should be counseled on the risks and benefits of refractive surgery, including suboptimal surgical outcomes, especially given their history [ 30 ].…”