Importance of fundoscopy in refractive surgery

To examine the incidence, treatment, and outcomes of retinal lesions before and after refractive laser surgery.

Private refractive surgery practice.

A retrospective review was conducted of patients attending the laser clinic over a 3-year period. Examined were the incidence, type, management, and outcomes of the posterior segment abnormalities encountered.

Fifty two (1.1%) of 4800 patients had posterior segment pathology requiring intervention. Forty-five cases (0.86%) were detected preoperatively and had a mean refraction of -4.5 diopters (D) +/- 3.0 (SD). Seven cases (0.14%) were detected postoperatively at a mean follow-up of 19 +/- 18.3 months; none had preoperative pathology. The mean refraction in this group was -4.4 +/- 2.3 D. Ninety-five percent had myopic prescriptions. All maintained best corrected visual acuity postoperatively. The incidence of retinal detachment was 0.03% per year in the myopic candidates; however, no cases occurred after the refractive procedure.

Dilated fundus examination is an integral part of optimum clinical care in refractive patients, and shared preoperative assessment by a retinal specialist is advisable in those with predisposing retinal pathology.