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Considerations for patients with diabetes and Lasik, PRK, LASEK, Epi-Lasik, etc..

Image of glucose test meter.  
Diabetes needs to be fully managed before Lasik or similar refractive surgery.  

Diabetes alone does not automatically exclude a patient from conventional or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, or other refractive surgery, but there are two important considerations.

Less Predictability

Patients with type I diabetes, those requiring insulin to control their blood sugar, and type II diabetes both have a higher probability of requiring enhancement surgery because corneal ablation is somewhat less predictable than in patients without diabetes.

Vision Disorders

People with Type I diabetes and patients with diabetes for many years, are at an increased risk for developing diabetic retinopathy. Poor control of the blood glucose, pregnancy, uncontrolled hypertension and smoking all aggravate diabetic retinopathy.

Diabetic retinopathy is diagnosed through a complete eye exam by an eye specialist. It is recommended that diabetic patients receive a dilated eye exam at least once a year. If diabetic retinopathy is discovered, the frequency of exams will be increased.

Basically there are two methods to treat diabetic retinopathy – medical (preventive) and surgery. The medical approach is having the diabetic patient take the initiative in monitoring blood sugar levels in addition to controlling their diabetes by eating right. This will significantly reduce the chances of developing diabetic retinopathy or at least slow the progression of the disease. Laser surgery is another way to treat the diseased eye. The laser light can focus onto the retina selectively treating the desired area without damaging surrounding tissue.

If you have diabetic retinopathy, you should be evaluated by an ophthalmologist who specializes in retina disease prior to refractive surgery.

Blindness Risk

Diabetes is the most common cause of blindness in working age adults. It is a disease that affects the body’s ability to utilize sugar. As a consequence, high levels of sugar build up in the blood and tissues causing damage to the body’s organs. One of the most commonly affected organs is the eye; this is known as diabetic retinopathy.

Diabetes damages the blood vessels that nourish the retina, it causes the retina vessels to sprout tiny leaks or microaneurysms that makes the surrounding retina swell and not work properly. Central vision can become blurred. However, once the diabetes is under control, vision usually returns to normal. Sometimes blurred vision can be the first symptom of diabetes and may lead to the initial diagnosis of the disease.

Increased Intraocular Pressure (IOP)

During Lasik, Bladeless Lasik, and Epi-Lasik, a microkeratome is affixed to the eye with suction. This suction dramatically increases the IOP temporarily. This increase in IOP can affect the blood vessels in the eye that may be compromised due to diabetes. For this reason, these techniques probably should be avoided. Investigate instead PRK, LASEK, Intacs, P-IOL, or RLE.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Diabetes Medical Journal Articles...

Related Articles

LASIK and systemic contraindications.

Ophthalmology. 2007 May;114(5):1032-3; author reply 1033-4

Authors: Mohammadpour M

PMID: 17467541 [PubMed - indexed for MEDLINE]


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