Refractive surgery for the patient with autoimmune diseases

Area of Science:

• Ophthalmology
• Immunology
• Surgical Innovation

Background:

• Current US FDA guidelines contraindicate laser refractive surgery (LRS) for patients with autoimmune diseases.
• These guidelines stem from limited data and complications from other intraocular procedures.
• Recent research evaluating LRS safety and efficacy in this population is scarce.

Purpose of the Study:

• To review existing research on LRS in patients with autoimmune diseases.
• To provide updated recommendations for evaluating and managing these patients.
• To address the efficacy and safety of LRS in individuals with immune-mediated conditions.

Main Methods:

• Systematic review of current clinical studies.
• Analysis of retrospective studies on refractive outcomes.
• Evaluation of reported complications in patients with autoimmune diseases.

Main Results:

• Retrospective studies indicate favorable refractive outcomes in patients with well-controlled autoimmune diseases (e.g., rheumatoid arthritis, lupus).
• No sight-threatening complications were reported in recent studies.
• Postoperative complication rates in these patients appear comparable to those without autoimmune diseases.

Conclusions:

• Patients with well-controlled autoimmune diseases, excluding primary Sjogren's syndrome, may be candidates for LRS.
• Informed consent regarding potential complications is crucial.
• Larger prospective studies are needed to further compare outcomes and risks.