Laser in situ keratomileusis in patients with diabetes

PURPOSE: To study the outcomes of laser in situ keratomileusis (LASIK) in patients with well-controlled diabetes mellitus. SETTING: Gimbel Eye Centres, Calgary and Edmonton, Canada. METHODS: The charts of all patients with diabetes who had LASIK surgery at the Gimbel Eye Centres were reviewed retrospectively. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), final refraction, and complications were assessed. RESULTS: Twenty-four patients (16 men and 8 women) were identified. Mean patient age was 42 years (range 24 to 57 years). Seventeen patients had diabetes type II, and 7 had diabetes type I. Mean preoperative spherical equivalent (SE) was -4.88 ± 2.13 diopters (D) (range +1.625 to -9.00 D). Median follow-up was 6 months (range 4 to 44 months). No eye lost BSCVA. Twenty-nine eyes (63%) achieved UCVA 20/25 or better, and 31 eyes (67%) were within ±0.5 D of the intended refraction after the first LASIK surgery. Retreatment was required in 13 eyes (28.3%) because initial surgery was not adequate to correct the refractive error. At the last follow-up visit, 40 eyes (87%) achieved UCVA of 20/25 or better and 43 eyes (93.5%) were within ±0.5 D of the intended refraction. Three eyes (6.5%) developed an epithelial defect after surgery, and secondary epithelial ingrowth developed in 2 of these eyes. No advancement of diabetic retinopathy was noticed in any eye at the end of the follow-up period. CONCLUSIONS: Laser in situ keratomileusis surgery was safely performed in patients with well-controlled diabetes. Enhancement may often be required for optimal correction.