title: Changing perspective of reasons for not performing laser-assisted in situ keratomileusis among candidates in a university eye clinic.
abstract: BACKGROUND
  The aim was to retrospectively analyse the reasons for not performing laser-assisted in situ keratomileusis (LASIK) surgery among refractive surgery candidates at a university eye clinic.
  
  
  METHODS
  Case records of patients who presented to a university eye clinic between June 2005 and June 2010 for consideration for LASIK surgery were examined. Cases that did not undergo LASIK were selected for analysis. Reasons for not performing surgery in these cases were analysed.
  
  
  RESULTS
  In total, 552 patients requested LASIK between July 2005 and June 2010 and 377 (68.3 per cent) of them received refractive surgery. Among 175 (31.7 per cent) patients who did not get LASIK, 62 (35.4 per cent) were male and 113 (64.6 per cent) were female, with a mean age at presentation of 36.4 ± 9.3 years (range: 19 to 78 years). The most common reasons for not offering LASIK were low corneal thickness (28.6 per cent), high myopia (15.4 per cent), large pupil (8.0 per cent) and keratoconus (7.4 per cent). Overall, 39 patients (22.3 per cent) changed their mind after their initial consultations with surgeons. The prevalence of rejection of LASIK decreased from 44.1 per cent between July 2005 and June 2006 to 3.5 per cent between July 2009 and June 2010.
  
  
  CONCLUSIONS
  Reasons for not performing refractive surgery are quite diverse. Inadequate corneal thickness and change of mind after initial consultation were the most common reasons in the present study. There was a marked change in magnitude and trend of reasons for not performing LASIK over the study period. Further studies from settings other than university hospitals would be beneficial to compare the trend in patient selection.
authors.affiliation: Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Kunyong
authors.initials: K
authors.lastname: Xu
authors.forename: Hamish D
authors.initials: HD
authors.lastname: McKee
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000473:pathology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D012029:Refraction, Ocular; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult