title: Medical considerations before refractive surgery retreatment.
abstract: We report a case of a significant hyperopic shift 2 years after myopic photorefractive keratectomy with an interim of stability. The patient was an otherwise healthy man who reported a sudden change in vision when climbing to altitude. Medical considerations for refractive shifts should be looked at before retreatment is proposed. Diabetes was diagnosed in our patient; after initiation of insulin, the patient's uncorrected visual acuity returned to 20/20 in both eyes.
authors.affiliation: Department of Ophthalmology, Naval Hospital, Camp Pendleton, California, USA. flykarin@aol.com
authors.forename: Karin E
authors.initials: KE
authors.lastname: Thomas
authors.forename: David J
authors.initials: DJ
authors.lastname: Tanzer
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D019781:Corneal Topography; D048909:Diabetes Complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000601:surgery; D007328:Insulin / Q000627:therapeutic use; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy; D012086:Reoperation; D014792:Visual Acuity
chemical_list: D001786:Blood Glucose; D007328:Insulin