Autoimmune and immune-mediated diseases are usually considered contraindications for laser refractive surgery. However, a new study suggests patients with autoimmune diseases other than Sjögren’s syndrome may do well with such procedures if their conditions are well controlled and they have minimal ophthalmic issues, a study in Current Opinion in Ophthalmology suggests.

FDA guidelines on refractive surgery to date are based on limited reports from other intraocular procedures, and only a handful of new clinical studies have evaluated efficacy and safety in this specific patient population, the research team from New Jersey noted in their paper.

Considering the findings of recent retrospective studies, the researchers cited patients with well-controlled autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus and seronegative spondyloarthropathy, had good refractive outcomes and no severe sight-threatening complications.

“Although postoperative complications occur, the risk of refractive surgery is comparable with those without autoimmune diseases,” the researchers wrote in their paper.

Patients should be made aware of potential surgical complications and also be informed of the current available data, the researchers noted. Additional multicenter and larger prospective studies are needed to compare the refractive outcomes and surgical complications in patients with and without autoimmune diseases, which will help patients make better-informed medical decisions, they added.

Chen TY, Chu DS. Refractive surgery for the patient with autoimmune diseases. Curr Opin Ophthalmol. May 13, 2020. [Epub ahead of print].