Department of Cataract and Refractive Surgery, Clínica Baviera, Bilbao, Spain.
Department of Cataract and Refractive Surgery, Clínica Baviera, Madrid, Spain.
Am J Ophthalmol. 2018 Aug;192:98-103. doi: 10.1016/j.ajo.2018.05.009. Epub 2018 Jun 1.
To determine the functional outcomes of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in patients taking isotretinoin, which is contraindicated for these procedures.
Multicenter, retrospective, interventional case series.
All patients taking isotretinoin who underwent LASIK or PRK from January 2003 to September 2017 were included (Group 1). Patients were compared with those undergoing LASIK or PRK who had taken isotretinoin previously but not in the previous 6 months (Group 2). Patients were included consecutively.
A total of 113 patients (219 eyes) were included. No significant intraoperative or postoperative complications were found. There were no significant differences between the groups in terms of visual acuity, postoperative spherical equivalent, efficacy index, predictability, or safety index. When only PRK patients were taken into account, the efficacy index (P = .017), postoperative sphere (P = .041), and postoperative astigmatism (P < .001) were better in Group 2, although the difference was not clinically relevant.
In our experience, LASIK and PRK can be performed effectively and safely in selected patients taking isotretinoin. The absolute exclusion of certain systemic medications should be reconsidered.
确定服用异维 A 酸（禁止进行 LASIK 和 PRK 手术）的患者行 LASIK 和光性折射性角膜切削术（PRK）后的功能结果。
多中心、回顾性、干预性病例系列研究。
所有于 2003 年 1 月至 2017 年 9 月期间因服用异维 A 酸而行 LASIK 或 PRK 的患者均被纳入（第 1 组）。将这些患者与之前服用过异维 A 酸但在过去 6 个月内未服用的患者（第 2 组）进行比较。患者被连续纳入。
共纳入 113 例患者（219 只眼）。未发现明显的术中或术后并发症。两组患者的视力、术后球镜等效值、有效性指数、可预测性和安全性指数均无显著差异。仅考虑 PRK 患者时，第 2 组的有效性指数（P =.017）、术后球镜（P =.041）和术后散光（P <.001）更好，但差异无临床意义。
根据我们的经验，在服用异维 A 酸的特定患者中，可有效且安全地行 LASIK 和 PRK。应重新考虑绝对排除某些全身药物的做法。
