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Laser-Assisted In Situ Keratomileusis Complications in Diabetes Mellitus

Fraunfelder, Frederick W. M.D.; Rich, Larry F. M.D.

Clinical Sciences

Purpose. To report the incidence of complications and the refractive results in patients with diabetes mellitus treated with laser-assisted in situ keratomileusis (LASIK).

Methods. A retrospective review of the charts, focusing on 6-month postoperative data, was performed on 30 eyes from patients with diabetes and 150 age- and gender-matched control eyes operated on during the same period. The incidence of complications and postoperative refractive results were compared. The data analyzed include UCVA, spherical equivalent, astigmatism power, astigmatism axis, and vector astigmatism change.

Results. Diabetic eyes treated with LASIK had an overall complication rate of 47% compared with the control population complication incidence of 6.9% (p < 0.01). The most frequent complications occurring in the diabetic population are punctate epithelial erosions and persistent epithelial defects. Spherical correction change was −4.64 diopters (D) for diabetic eyes and −4.98 D for control eyes (p = 0.49). Mean spherical equivalent change was −4.69 D for diabetic eyes and −4.75 D for control eyes (p = 0.9). Mean change in uncorrected visual acuity (LogMAR) was 1.5 for diabetic eyes and 1.65 for control eyes (p = 0.18). Mean astigmatism magnitude change was 0.31 in diabetic eyes and 0.57 in control eyes (p = 0.12). Mean vector corrected astigmatism change was 0.97 for diabetic eyes and 1.12 for control eyes (p = 0.31). Mean vector-corrected astigmatism axis for patients with diabetes was 18.17 for diabetic eyes and 6.20 for control eyes (p = 0.30).

Conclusion. Patients with diabetes who undergo LASIK are at a significantly higher risk of developing postoperative epithelial complications. In addition, this study revealed poorer refractive results in the eyes of patients with diabetes treated with LASIK.

From the Cornea Service, Casey Eye Institute, Portland, Oregon, U.S.A.

Submitted July 16, 2001.

Revision received January 15, 2002.

Accepted January 20, 2002.

Supported in part by a grant from Research to Prevent Blindness

Address correspondence and reprint requests to Frederick W. Fraunfelder, M.D., 3375 SW Terwilliger Blvd., Portland, OR 97201, U.S.A. E-mail:

© 2002 Lippincott Williams & Wilkins, Inc.