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June 24, 2019 | Author: Admin
Grant Justin, MD, San Antonio, shared the result of a study at a recent ASCRS Meeting 2019 refractive surgery complications and risk Factor for HIV positive patients in the military. The objective of the study were to assess the frequency of refractive surgery performed on HIV positive active duty service member, retirees, and their dependents, and risk factors for postoperative complications in these patients.
The FDA recommends against refractive surgery in HIV positive patients or other individuals with immunodeficiencies, and the American Academy of Ophthalmology (AAO) says controlled autoimmune diseases are a relative contraindication for refractive surgery of 285 refractive surgeons found that about half of them consider HIV positive patients acceptable candidates for surgery, Dr. Justin said.
The new study analyzed refractive surgery frequency and outcomes in patients that were part of the Natural History Study a cohort of HIV positive active duty service members and retirees from the Department of Defense started in the early 1980s.
The study looked at patients from this cohort who had LASIK, PRK, and other corneal refractive procedures after being diagnosed as HIV positive. The result showed that none of the patients who received LASIK had any complications, but several patients who had received PRK and RK had complications involving corneal ulcers and Keratitis.
The study found it is critical to review a patient’s CD4 cell counts, viral loads, and whether they are on Highly Active Antiretroviral Therapy (HAART), Dr. Justin said. Patients who have poor compliance with their HAART medications may have poor compliance with postop drops, he said. He recommends surgeons consider doing unilateral surgery in these patients because of the risk of infection.
