Fibromyalgia and LASIK: outcomes, complication rates, and ocular pain risk

To compare post-laser in situ keratomileusis (LASIK) complications and self-reported ocular pain in patients with fibromyalgia (FM) vs healthy controls.

Multisurgeon multicenter standardized protocol practice.

Retrospective case-control series.

1148 eyes from 574 patients with confirmed FM and 54 104 eyes from healthy controls were included. Main outcome measures were incidence of postoperative complications, dry eye (punctate epithelial erosions [PEEs] grade ≥ 2), and self-reported ocular pain. Secondary outcomes included visual and refractive outcomes.

The median time since surgery was 6 years (range: 3 to 13 years). FM incidence in the study population was 0.25% (1 in 400 patients). Postoperative dry eye incidence (PEE grade ≥ 2) was 0.61% in FM eyes vs 0.37% in controls ( P = .3). Self-reported postoperative pain occurred in 0.97% of FM eyes vs 0.75% of controls ( P = .4). Postoperative complications occurred in 2.00% of FM eyes and 2.35% of controls ( P = .4), with no cases of postoperative corneal neuralgia in patients with FM. Visual outcomes showed good efficacy, with 83% of FM eyes achieving 20/20 uncorrected distance visual acuity monocularly. The safety index was 0.99, with 95% of FM eyes maintaining or improving preoperative corrected distance visual acuity, consistent with controls.

FM was not associated with an increased risk of self-reported pain or post-LASIK corneal neuralgia. Refractive and visual outcomes, as well as postoperative complications, were comparable with non-FM patients. These findings suggest that a preoperative history of FM alone should not be considered an absolute contraindication for LASIK.