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Outcomes Post Laser-In-Situ Keratomileusis in HIV+ Patient Population

Outcomes Post Laser-In-Situ Keratomileusis in HIV+ Patient Population. Arusha Gupta, MD 1 , Christopher Coad MD 1,2 , Joseph A.  Eviatar MD 1,2 ;  Newberry, Ashley 2 New York Eye and Ear Infirmary, NY, NY Chelsea Eye and Cosmetic Surgery Associates , NY, NY.

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Outcomes Post Laser-In-Situ Keratomileusis in HIV+ Patient Population

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  1. Outcomes Post Laser-In-Situ Keratomileusis in HIV+ Patient Population Arusha Gupta, MD1, Christopher Coad MD1,2, Joseph A.  Eviatar MD1,2;  Newberry, Ashley2 New York Eye and Ear Infirmary, NY, NY Chelsea Eye and Cosmetic Surgery Associates , NY, NY Authors have no financial interest in the subject matter of this poster.

  2. Purpose • Laser-in-situ keratomileusis(Lasik) is considered a relative contraindication in the immunocompromised. • This contraindication is predicated on poor wound healing capabilities in this patient population. • In this report we describe the visual acuity outcomes and complications associated with Lasik in a group of HIV+ patients compared to a control population.

  3. Methods • A retrospective chart review of 71 patients (134 eyes) who underwent LASIK (customvue intralase) between 2006-2008, with a minimum 3 month follow up period, was performed.   • Controls were equally selected over the three years to exclude bias. • Patient post-op target visual acuity and patients that had post-operative complications such as dry eye syndrome, infectious keratitis, and flap dislocation were identified. 

  4. Results • There were 36 patients (67 eyes) in the control group and 35 patients (67 eyes) in the study group. • The mean age of the control group was 40.9 +/- 6.5 yrs and of the study group was 42.0 +/- 6.7 years. • The mean pre-op sphere was -3.8 +/- 1.9 D for the control group and -2.7 +/- 2.3 D for the study group • The mean pre-op cylinder was -0.9 +/- 0.8 for the control group and -0.9 +/- 1.1 for the study group. 

  5. Results • The intended post-op visual acuity was achieved in 65/67 eyes (97%) in the control group and 64/67 eyes (95.5%) in the study group. • These results were not statistically significant with p-value >0.05 •  In each group 2 eyes (1 patient) had flap dislocations.  • In the study group, 3 eyes (2 patients) developed dry eyes (p<0.05) for a period of 1 year or less that was alleviated with the use of prescription dry eye medication or punctal plugs.  • There were no developments of infectious keratitis in either group. 

  6. Results

  7. Discussion • Based on the preliminary data: • The outcomes for HIV+ patients who underwent Lasik surgery in this practice had outcomes equal to that of the uninfected population. • There may be a higher incidence of development of dry eyes syndrome in HIV+ patients. • There was no evidence of higher rate of infection in HIV+ patients

  8. Discussion • However, long term follow up of a large group of patients greater than three months has not been completed at this time. It is unknown if HIV+ patients will be more susceptible to opportunistic corneal infections. • The HIV+ population involved in this study presented to a practice in an affluent area in New York City, therefore, the outcomes may be biased and it may not be conclusive when considering the HIV population at large.

  9. Conclusion • In this series, there is no significant difference between the post-operative visual acuity outcome and rate of infectious keratitis in patients with HIV versus control patients but patients with HIV may have a higher incidence of developing dry eyes after LASIK. 

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