This multicentre, retrospective, interventional case series assesses the outcomes of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in 113 patients taking isotretinoin between January 2003 and September 2017. Isotretinoin is contraindicated for LASIK and PRK and patients are currently required to wait six months after stopping before laser refractive surgery and should not restart treatment in the early postoperative period. This study compared those that were currently taking isotretinoin who underwent LASIK or PRK (group 1: 158 eyes) to those who had previously taken the drug but not in the past six months (group 2: 61 eyes). All patients had a stable refraction for at least a year and all procedures were performed according to standard protocol. The study found that there was no significant difference in refractive outcome between the two groups. The article also reports that there was no intraoperative complications or postoperative complications in either group. Therefore concluding that LASIK and PRK can be performed safely in patients taking isotretinoin and that it should be removed from the list of contraindicated systemic medication. This study on its own, however, does not ‘prove’ that LASIK and PRK are safe in these patients. Larger studies should be considered, including additional data such as Ocular Surface Disease index or Oxford grading at the slit-lamp to ensure patients have an unaltered tear film.

Outcomes of laser in situ keratomileusis and photorefractive keratectomy in patients taking isotretinoin.
Ortega-Usobiaga J, Llovet-Osuna F, Djodeyre M, et al.
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Tasmin Berman

University of Liverpool, Liverpool, UK.

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