TY - JOUR
T1 - Update on contraindications for laser-assisted in situ keratomileusis and photorefractive keratectomy
AU - Bower, Kraig S.
AU - Woreta, Fasika
PY - 2014/7
Y1 - 2014/7
N2 - PURPOSE OF REVIEW: Laser refractive surgery (LRS) is one of the most common elective procedures performed in the USA today. Patients should be rigorously screened for certain ocular and systemic conditions, which may represent contraindications to LRS. Before treating, the refractive surgeon should be aware of the Food and Drug Administration (FDA) labeling for the procedure as well as what other evidence, such as clinical studies, case series, cases reports, and anecdotal evidence, exists. The purpose of this article is to review contraindications to having LRS. RECENT FINDINGS: Ocular contraindications to LRS include unstable refractive error, corneal ectatic disorders, a history of herpetic keratitis, Avellino corneal dystrophy, significant cataract, and uncontrolled glaucoma. LRS should also be avoided in uncontrolled diabetes, collagen vascular disease (CVD), pregnancy, and in patients taking amiodarone and isotretinoin. SUMMARY: Current contraindicatisons to LRS are based on FDA labeling and guidelines from the American Academy of Ophthalmology. Much of the evidence is based on case reports or series, anecdotal evidence, or known complications from nonlaser ocular surgery. More randomized clinical trials are needed to establish the safety of LRS in controversial conditions such as well controlled CVD.
AB - PURPOSE OF REVIEW: Laser refractive surgery (LRS) is one of the most common elective procedures performed in the USA today. Patients should be rigorously screened for certain ocular and systemic conditions, which may represent contraindications to LRS. Before treating, the refractive surgeon should be aware of the Food and Drug Administration (FDA) labeling for the procedure as well as what other evidence, such as clinical studies, case series, cases reports, and anecdotal evidence, exists. The purpose of this article is to review contraindications to having LRS. RECENT FINDINGS: Ocular contraindications to LRS include unstable refractive error, corneal ectatic disorders, a history of herpetic keratitis, Avellino corneal dystrophy, significant cataract, and uncontrolled glaucoma. LRS should also be avoided in uncontrolled diabetes, collagen vascular disease (CVD), pregnancy, and in patients taking amiodarone and isotretinoin. SUMMARY: Current contraindicatisons to LRS are based on FDA labeling and guidelines from the American Academy of Ophthalmology. Much of the evidence is based on case reports or series, anecdotal evidence, or known complications from nonlaser ocular surgery. More randomized clinical trials are needed to establish the safety of LRS in controversial conditions such as well controlled CVD.
KW - Complications
KW - Contraindications
KW - Laser-assisted in situ keratomileusis
KW - Photorefractive keratectomy
UR - http://www.scopus.com/inward/record.url?scp=84902247897&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902247897&partnerID=8YFLogxK
U2 - 10.1097/ICU.0000000000000055
DO - 10.1097/ICU.0000000000000055
M3 - Review article
C2 - 24837576
AN - SCOPUS:84902247897
SN - 1040-8738
VL - 25
SP - 251
EP - 257
JO - Current opinion in ophthalmology
JF - Current opinion in ophthalmology
IS - 4
ER -