Implications of Corneal Refractive Surgery in Patients with Fabry Disease

Fabry disease is an X-linked lysosomal storage disorder involving abnormal metabolism of glycosphingolipids, resulting in a range of multisystem organ dysfunction and ocular manifestations. Reports of laser-assisted in situ keratomileuses (LASIK) and photorefractive keratectomy (PRK) are lacking in this patient population. Proceeding with corneal refractive surgery in patients with Fabry disease raises concerns regarding the pre-existing corneal manifestations, reduced mesopic visual acuity, the potential for conjunctival lymphangiectasia, and predisposition to dry eye syndrome. This commentary discusses the current understanding of Fabry disease, including its ocular manifestations, and explores factors to consider when evaluating these patients for LASIK or PRK.