LASIK for Patients with Autoimmune Diseases

The review article “Refractive Surgery for the Patient with Autoimmune Diseases,” published in Current Opinion in Ophthalmology in July 2020, delves into the nuanced considerations necessary when performing laser refractive surgeries on patients with autoimmune and immune-mediated diseases.

Key Findings:

1. Objective: The review’s primary goal was to examine the current research and provide updated recommendations for evaluating and managing laser refractive surgery (LRS) in patients with autoimmune diseases. The FDA currently lists autoimmune diseases as contraindications for LRS, based on limited case reports and intraocular procedure complications.
2. Methods: The article reviewed existing research and clinical studies on the efficacy and safety of LASIK in patients with autoimmune diseases. Although few new clinical studies specifically address this population, the review aimed to summarize recent findings and offer guidance.
3. Results: Recent retrospective studies have shown promising refractive outcomes in patients with well-controlled autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and seronegative spondyloarthropathies. No severe, sight-threatening complications were reported in these studies. Despite the occurrence of postoperative complications, the risk associated with LRS was comparable to that of patients without autoimmune diseases.
4. Conclusions: With the exception of primary Sjogren’s syndrome, patients with controlled autoimmune diseases and minimal ophthalmic manifestations may be suitable candidates for LASIK. However, patients must be informed of potential surgical complications based on the currently available data.

Implications for Practices: At The LASIK.com Network, patient safety and informed decision-making are paramount. This review underscores the importance of thorough preoperative assessments and patient education. While the findings suggest that LASIK can be safe for patients with controlled autoimmune conditions, each case must be evaluated individually. We will continue to monitor emerging research to refine our practices and ensure the best outcomes for our patients.

In conclusion, while LASIK may be a viable option for some patients with autoimmune diseases, careful patient selection and management are crucial. Ongoing research and larger prospective studies will be vital in guiding future recommendations and improving patient care.

Refractive Surgery for the Patient with Autoimmune Diseases

Authors: Tony Y. Chen, David S. Chu

Published in: Current Opinion in Ophthalmology, July 2020, Volume 31, Issue 4, p 247-252. DOI: 10.1097/ICU.0000000000000668.

Purpose of review: Autoimmune and immune-mediated diseases are considered contraindications for laser refractive surgeries according to the US Food and Drug Administration’s guidelines. This guideline, however, is based on limited case reports or complications reported during other intraocular procedures. The review evaluates the efficacy and safety of refractive surgery in this specific patient population and offers updated recommendations for the evaluation and management of LRS in patients with autoimmune diseases.

Recent findings: More recent retrospective studies have reported good refractive outcomes in patients with well-controlled autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and seronegative spondyloarthropathy, among others. No severe sight-threatening complications have been reported in these reports. Although postoperative complications occur, the risk of refractive surgery is comparable with those without autoimmune diseases.

Summary: With the exception of primary Sjogren’s syndrome, patients with autoimmune diseases may be good candidates for LRS if diseases are well controlled and have minimal ophthalmic manifestation. Patients should be informed of potential surgical complications and the limitations of currently available data. More multicenter and larger prospective studies are needed to compare refractive outcomes and surgical complications in patients with and without autoimmune diseases. This will help patients make better-informed medical decisions.