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E. M. Krantz, K. J. Cruickshanks, B. E. K. Klein, R. Klein, G. H. Huang, F. J. Nieto, D. S. Dalton; Refractive Surgery in a Population. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2442.
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To report the prevalence of refractive surgery and compare those who elected to undergo refractive surgery to those who did not.
The Beaver Dam Offspring Study included self-report of ever having refractive surgery, and examination measures of contrast sensitivity (CS) using Pelli-Robson charts, visual acuity (VA) using a modified Bailey-Lovie LogMAR chart, age-related macular degeneration (AMD) using digital fundus photos, and cataracts using retro-illumination and slit-lamp photos. CS impairment was defined as log triplet score<1.55. Logistic regression was used to compare those with and without refractive surgery. Of 4965 eligible, 3285 (66%) participated.
A total of 174 (5%) participants reported refractive surgery. Of those, 85% reported LASIK for type of surgery, and 16% reported re-treatment on either eye. Prevalence rates for refractive surgery did not vary significantly by sex (4.9% for men vs. 5.6% for women), but those with refractive surgery were significantly younger than those without (mean age 47 vs. 49 years, p=0.001). Adjusting for age, higher levels of education (p=0.003) and income (p<0.001) were also associated with refractive surgery. Best corrected VA and CS impairment were not significantly different for those with and without refractive surgery when adjusting for age, income, education, dry eyes, and any cataract or AMD. However, more participants with refractive surgery than without reported having dry eyes frequently or all of the time (13% vs. 7% respectively, adjusted OR=2.14, 95% CI 1.24, 3.68). Current use of corrective lenses differed between those who did and did not report refractive surgery with 4% vs. 7% respectively using lenses for distance only, 10% vs. 54% using lenses for both distance and near work, and 34% vs. 23% using lenses for near work only (p<0.001). These differences remained significant in adjusted analyses.
Although people who have undergone refractive surgery may have good vision and less need for corrective lenses than those without surgery, this treatment often does not eliminate the need for wearing corrective lenses, and may be associated with increased frequency of dry eyes.
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