Outcomes Post Laser-In-Situ Keratomileusis in HIV+ Patient Population Arusha Gupta, MD1, Christopher Coad MD1,2, Joseph A.  Eviatar MD1,2;  Newberry, Ashley2 New York Eye and Ear Infirmary, NY, NY Chelsea Eye and Cosmetic Surgery Associates , NY, NY Authors have no financial interest in the subject matter of this poster.

Purpose Laser-in-situ keratomileusis(Lasik) is considered a relative contraindication in the immunocompromised. This contraindication is predicated on poor wound healing capabilities in this patient population. In this report we describe the visual acuity outcomes and complications associated with Lasik in a group of HIV+ patients compared to a control population.

Methods A retrospective chart review of 71 patients (134 eyes) who underwent LASIK (customvue intralase) between 2006-2008, with a minimum 3 month follow up period, was performed.   Controls were equally selected over the three years to exclude bias. Patient post-op target visual acuity and patients that had post-operative complications such as dry eye syndrome, infectious keratitis, and flap dislocation were identified. 

Results There were 36 patients (67 eyes) in the control group and 35 patients (67 eyes) in the study group. The mean age of the control group was 40.9 +/- 6.5 yrs and of the study group was 42.0 +/- 6.7 years. The mean pre-op sphere was -3.8 +/- 1.9 D for the control group and -2.7 +/- 2.3 D for the study group The mean pre-op cylinder was -0.9 +/- 0.8 for the control group and -0.9 +/- 1.1 for the study group. 

Results The intended post-op visual acuity was achieved in 65/67 eyes (97%) in the control group and 64/67 eyes (95.5%) in the study group. These results were not statistically significant with p-value >0.05  In each group 2 eyes (1 patient) had flap dislocations.  In the study group, 3 eyes (2 patients) developed dry eyes (p<0.05) for a period of 1 year or less that was alleviated with the use of prescription dry eye medication or punctal plugs.  There were no developments of infectious keratitis in either group. 

Results Control Group Study Group N (eyes) 67 Mean Age (yrs) 40.9 42 Mean Pre-op Sphere -3.8 -2.7 Mean Pre-op Cylinder -0.9 Flap dislocations 2 Dry Eyes 3 Infectious keratitis

Discussion Based on the preliminary data: The outcomes for HIV+ patients who underwent Lasik surgery in this practice had outcomes equal to that of the uninfected population. There may be a higher incidence of development of dry eyes syndrome in HIV+ patients. There was no evidence of higher rate of infection in HIV+ patients

Discussion  However, long term follow up of a large group of patients greater than three months has not been completed at this time. It is unknown if HIV+ patients will be more susceptible to opportunistic corneal infections. The HIV+ population involved in this study presented to a practice in an affluent area in New York City, therefore, the outcomes may be biased and it may not be conclusive when considering the HIV population at large.

Conclusion In this series, there is no significant difference between the post-operative visual acuity outcome and rate of infectious keratitis in patients with HIV versus control patients but patients with HIV may have a higher incidence of developing dry eyes after LASIK.