Post–operative LASIK Referrals to a Tertiary Care eye Center

Abstract

Abstract: : Purpose: to report on the post–operative laser in situ keratomileusis (LASIK) referrals to a tertiary care cornea Service. Methods: Retrospective review of the charts of one hundred fifty six (156) consecutives patients referred to the Cornea Service at Wills Eye Hospital (July 1996 to June 2003) after having LASIK elsewhere. Results: The most common diagnosis was irregular astigmatism that was found in 48.76% of the cases, followed by undercorrection or regression in 16.52% and anterior basement membrane dystrophy, epithelial defect, or recurrent erosions in another 16.52%. Of less common but more devastating complications were corneal ectasia in 6.61% and corneal ulcer in 1.24% of the cases. Almost seventy percent of the cases were referred for problems that could be managed with conservative medical therapy. Over thirty–five percent of the cases were offered contact lenses wear, 22% were recommended spectacles to improve vision. In thirty percent of the cases were offered a surgical intervention. Penetrating keratoplasty was recommended in 4.54% cases. Only 32% of the patients were referred by their surgeons. Twenty eight percent of the patients were self–referred, and 40% were referred by another doctor. Conclusions: Only one third of the patients were referred by their surgeons indicating that many patients are unhappy enough with their doctor to seek an additional opinion. Although the majority of the patients presented with a problem that could be managed with conservative medical therapy, a small number of cases suffered severe complications post– LASIK that required surgical intervention. These complications may be minimized by a thorough preoperative evaluation and meticulous attention to detail preoperatively, intraoperatively, and postoperatively.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • refractive surgery: complications • refractive surgery: LASIK