Original ArticlesAvoiding serious corneal complications of laser assisted in situ keratomileusis and photorefractive keratectomy☆
Section snippets
Methods
The study was of a noncomparative case series and was performed by chart review. Institutional review board approval was not obtained. There is no established definition of a serious laser refractive complication, thus the inclusion criteria were: (1) patient referred for further opinion for diagnosis and management of a laser refractive complication; (2) loss of two or more lines of best spectacle-corrected visual acuity (BSCVA), loss of quality of vision such as to interfere with the
Results
Twenty seven eyes of 19 patients were included in the study. Seventeen patients were operated on by one surgeon, with one patient each from two other surgeons. Four patients were referred by their refractive surgeon but most (n = 14) were referred by optometrists without the knowledge of the surgeon. One patient was self-referred.
Discussion
Laser refractive surgery, particularly LASIK, is expanding rapidly and even a low rate of serious complications is of great importance. We studied 27 eyes of 19 patients (PRK, n = 8; LASIK, n = 19) to determine if there were avoidable factors in the development of the complication. Patient were considered to have serious complication if they were visually disabled to the extent they had difficulty with their daily activities, either by virtue of reduced BCVA of more than two lines or decreased
Conclusion
We are unable to draw definite conclusions as to the avoidable factors for serious complications of LASIK and PRK based on this study. Despite the inherent biases in the case selection and definitions, we are concerned by the number of serious complications: 27 eyes in 19 patients accumulated in 18 months. Recognizing the difficulties in drawing conclusions from this group of patients, we do consider that there are several avoidable factors that other laser refractive surgeons may consider in
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Supported by The Eye Bank of British Columbia (SH).