title: Refractive surgery in systemic and autoimmune disease.
abstract: Patients with underlying systemic disease represent challenging treatment dilemma to the refractive surgeon. The refractive error in this patient population is accompanied by a systemic disease that may have an ocular or even a corneal component. The literature is rather sparse about the use of laser refractive surgery (LRS) and such procedure is not approved by the United States Food and Drug Administration (FDA) in this patient population. Patients with collagen vascular disease, diabetes mellitus (DM), allergic and atopic disease, or human immunodeficiency virus (HIV) are never ideal for LRS. Patients with uncontrolled systemic disease or ocular involvement of the disease should not undergo LRS. However, a patient with well-controlled and mild disease, no ocular involvement, and not on multidrug regimen may be a suitable candidate if they meet stringent criteria. There is a need for a large, multicenter, controlled trial to address the safety and efficacy of LRS in patients with systemic disease before such technology can be widely adopted by the refractive surgery community.
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Majed
authors.initials: M
authors.lastname: AlKharashi
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Stark
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Yassine J
authors.initials: YJ
authors.lastname: Daoud
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications*; D048988:Corneal Surgery, Laser; D048909:Diabetes Complications; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications*; D008297:Male; D011247:Pregnancy; D012216:Rheumatic Diseases / Q000150:complications; D016896:Treatment Outcome
keywords: Allergic and Atopic Disease; Collagen Vascular Disease; Diabetes Mellitus; HIV; Keloid; Laser Refractive Surgery; Pregnancy