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Julie Marie Schallhorn, Steven C Schallhorn; Laser vision correction in the setting of systemic collagen vascular disorders. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4848. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe outcomes, complications and patient satisfaction after LASIK in a large popuplation of patients with well-controlled collagen vascular disorders.
The records of Optical Express (Glasgow, UK), a large provider of LVC, were searched to identify patients with a history of collagen vascular disease that had undergone LASIK. Patients were permitted to have surgery if thier disease had been well-controlled for 6 months and the patients had no ocular complications and there were no clinical signs of keratoconjunctivitis sicca. Included diseases were as follows: rheumatoid arthritis (RA), systemic lupus erythematosis (SLE), psoriatitc arthritis (PsA), ankylosing spondylitis (AS), scleroderma (Scl), Sjogren’s syndrome (SS), mixed connective tissue disorder (MCT), and polymyalgia rheumatica (PMR). Information was collected on duration of rheumatologic condition, current medications, preoperative and postoperative best-corrected vision (BCVA), manifest spherical equivalent (MSE), dry eye symptoms using a standardized questionnaire, and overall satisfaction with the procedure.
A total of 290 patients (594 eyes) were identified. The average age was 45.9 ± 11.5 years (range 19 to 69 years), and the population was 70% female. The majority of patients (59%) had RA, followed by 21.4% with SLE, 14.5% with PsA, 1.4% with Scl, 1% with AS, and 0.3% each with SS, MCT, and PMR. The majority of patients (23%) were controlled on methotrexate, followed by 9% on hydroxychloroquine, 4% on sulfsalazine, 3% on diclofenac, 2% on acetaminophen, 1.7% on prednisone, and 1% each on qunine and etanercept. A total of 43% of patients were on no systemic therapy at time of treatment. Treatments were for myopia (average MSE -2.91 ± 1.85D) in 70% and hyperopia (average MSE +1.99 ± 0.89D) in 30%. Postoperatively, 78% of patients had a monocular BCVA of 20/20 or better, and 90% of patients had a binocular BCVA of 20/20 or better. 82% of patients had none to mild dry eye symptoms preoperative, and 75% of patients reported none to mild dry eye symptoms postoperative. Overall, 81% of patients reported they were satisfied or very satisfied with the outcome, and 89% would recommend treatment to a friend. No patient experienced a corneal melt.
LASIK can be safely performed on patients with well-controlled collagen vascular disorders. Both clinical outcomes and patient satisfaction are favorable.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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