Outcomes of Laser In Situ Keratomileusis and Photorefractive Keratectomy in Patients Taking Isotretinoin.

Abstract

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.