RESEARCH ARTICLE


Comorbidities in Corneal Refractive Surgery Candidates: A Cross-Sectional Study



Phit Upaphong1, 2, Napaporn Tananuvat1, 2, Somsanguan Ausayakhun1, 2, Winai Chaidaroon1, 2, Chulaluck Tangmonkongvoragul1, 2, Muanploy Niparugs1, 2, *
1 Department of Ophthalmology, Cornea and Refractive Surgery Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
2 Chiang Mai University LASIK Center, Center of Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand


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Creative Commons License
© 2022 Upaphong et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology, Cornea and Refractive Surgery Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Tel: 66-53935512; Fax: 66-53936121;
E-mail: mniparugs@gmail.com


Abstract

Background:

Individuals with refractive errors sometimes have other associated ocular and systemic abnormalities.

Objectives:

To explore ocular and systemic comorbidities in Corneal Refractive Surgery (CRS) candidates and to examine any contraindications for CRS.

Methods:

This was a cross-sectional study. Medical records of individuals who underwent a refractive surgery screening at Chiang Mai University LASIK Center, Chiang Mai, Thailand, were reviewed. All clinical data of the initial visit were evaluated. Eyes with a history of CRS and phototherapeutic keratectomy were excluded.

Results:

A total of 1,167 cases (2,334 eyes) were recruited, out of which 643 cases were females (55.09%). Myopia was the most common type of refractive error (2,120 eyes, 90.83%), and 868 (40.94%) eyes had high myopia. Approximately 45% (n=526) of the cases had worn contact lenses. The five most common ocular comorbidities (eyes, proportion) included keratoconus suspect (297, 12.72%), cataract (246, 10.53%), dry eye/probable dry eye (208, 8.91%), glaucoma suspect (184, 7.88%), and amblyopia (149, 6.38%). The most common systemic conditions that affected choices or outcomes of CRS were hypertrophic scar/keloid (169 cases, 14.48%) followed by allergy/asthma (127 cases, 10.88%). A total of 1,028 eyes (44.04%) were excluded from CRS, mainly due to abnormal corneal topography (470/1,028 eyes, 45.72%).

Conclusion:

Most refractive candidates were myopic and contact lens wearers. Serious ocular sequelae from myopia and contact lens use were not uncommon. Additionally, systemic diseases regularly affected the CRS options. The most common contraindication for CRS was abnormal corneal topography. Our study, thus, emphasizes the need for thorough ocular and systemic screenings of refractive candidates.

Keywords: Demography, LASIK, Myopia, PRK, Screening, Systemic disease.