Is Lasik Safe For Diabetics?

September 10, 2018
Is Lasik Safe For Diabetics?

Is Lasik Safe For Diabetics?

Is Lasik Safe For Diabetics?Is Lasik safe for people with diabetes? When we talk about refractive surgery, we refer to a variety of eye surgeries performed to correct refractive errors and thereby reduce or eliminate the patient’s need to wear glasses or contact lenses. Refractive errors include myopia(nearsightedness), hyperopia (farsightedness) and astigmatism.

Currently, the most popular and effective refractive surgery is ‘in situ laser keratomileusis’ (LASIK), an ambulatory surgical procedure that improves vision by remodeling the frontal surface of the eye (cornea) with an excimer laser. 

In LASIK, an extremely sharp keratome is used to create an articulated flap of corneal tissue. The flap is folded back, and an extremely precise laser is used to cut exact amounts of the corneal stroma. Once the refractive error is corrected, the flap is repositioned in its original place without sutures. Speak with a specialist at the Yaldo Eye Center Michigan lasik centerLASIK procedures represent approximately 90% of the refractive eye surgeries performed in the US. Currently, multiple studies are carried out that aim to develop new techniques to improve the results and reduce the complications of laser refractive surgery.

A few years ago, the Food and Drug Administration of the United States (FDA) published a list of ocular and systemic contraindications for refractive surgery, which included diabetes mellitus within the relative systemic contraindications. However, when these recommendations were published, limited data were available on the outcome of refractive surgery in diabetic patients, so the FDA based its recommendations on studies about nonlaser ocular surgery in patients with diabetes.

The inclusion of diabetes as a relative contraindication for refractive surgery was justified due to the possibility that the sudden ocular hypertension caused by suction and the microkeratome affected the blood flow in the retina and in the choroid, which could cause the appearance or aggravation of areas of ischemia or the increase of macular edema, and that in addition the alterations in the healing suffered by these patients could lead to significant corneal complications.

A recent publication by the American Academy of Ophthalmology cataloged well-controlled diabetic disease as a relative contraindication and only uncontrolled illness as an absolute systemic contraindication. However, these guidelines remain confusing, and in practice, most surgeons exclude patients with diabetes from refractory surgery, even asymptomatic and stabilized patients.

Lasik for People with Diabetes

LASIK Post-Op ExpectationsIt is important to mention that there are no reliable scientific studies to support the contraindication of diabetes mellitus to the LASIK procedure, the few reports published are based on isolated cases and contradictory opinions of different doctors.

While a LASIK procedure may seem like a good solution to correct refractive errors in people with diabetes, those patients who have difficulty controlling their blood sugar levels may continue to have vision problems after surgery.

Some statistics show that people with diabetes have a higher incidence of complications after a refractive surgical procedure compared to people without diabetes. These statistics highlight the need for more caution when considering laser refractive surgery in people with diabetes. Before using the LASIK method, patients must undergo a comprehensive examination to guarantee successful refractive surgery. The detailed evaluation of the retina, the thorough analysis with the slit lamp, the assessment of the tear film and the epithelial tests reduce the rate of complications in individuals with diabetes undergoing laser surgery.

Patients with diabetes should be informed of their increased risk of postoperative Lasik complications, and the ophthalmologist should proceed carefully in this patient population to avoid adverse events. It is mandatory to perform a thorough examination of a diabetic patient before performing refractive eye surgery. First, the patient must maintain optimal blood sugar levels. Second, the patient should not have pre-existing diabetic eye complications, such as an unhealthy ocular surface, cataracts, retinopathy of any kind, fragile retinal vasculature or neovascularization secondary to diabetes. Michigan Lasik eye surgery is a very complex procedure and requires a top Michigan Lasik eye surgeon to do it correctly.

Due to its reduced period of postoperative healing, Lasik surgery is more recommended in diabetic patients compared to other laser refractive surgeries such as PRK. It is recommended to avoid the use of eye drops, specifically anesthetic agents, one week before surgery because they can increase epithelial fragility.

Several clinical studies have shown that certain growth factors and cytokines can significantly improve epithelial proliferation and migration, with the consequent acceleration of wound healing after surgery. Recently researches endorsed the effectiveness of local/topical administration of insulin, naltrexone (opioid antagonist) or nicergoline (an ergoline derivative) to improve the healing speed of the corneal wound.

These growth factors and therapeutic agents could improve the healing of corneal wounds and increase the possibility of the clinical use of these agents as a new generation of ophthalmic pharmaceuticals to reduce the possible postoperative complications of patients with diabetes. For Lasik eye surgery in Michigan, trust your eyes with Dr. Yaldo.

Posted in News by Luke Yaldo
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