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Hormone replacement therapy may increase regression after LASIK

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Women who use hormone replacement therapy are at an increased risk of regression after LASIK surgery than women who do not use the therapy, according to a study.

Michael O’Keefe, FRCS, and colleagues at the National University of Ireland in Dublin retrospectively studied 301 eyes of 170 patients who had LASIK for the correction of myopia. All patients were between –0.5 D and –8 D. Patients ranged in age from 21 to 59 years old. The mean age of the patients in the hormone replacement therapy (HRT) group was 48.5 years old, compared with 33.7 years old in the control group. The mean age of the women on birth control pills was 29.4 years old, and that group was compared to the control group as well, according to the study.

There were 44 eyes of 27 patients on HRT; 81 eyes of 44 control group patients; and 176 eyes of 99 patients on birth control pills. The mean preop spherical equivalent refraction was –4.25 D in the groups on HRT and oral contraceptives, compared with –3.77 D in the control group, the authors said.

At week 1, there was no difference in refractive outcome between the control and HRT groups. By month 2, however, refractive outcome was significantly worse in the HRT group than in the control group, and that trend continued through the 6-month follow-up. Age was found to have a significant effect on the refractive outcome, independent of HRT, the researchers said. Conversely, neither refraction nor visual acuity differed between the control group and the oral contraceptive group, they said.

The authors said, “This is the first study to investigate hormonal status and refractive and visual acuity results after LASIK.” Women on HRT have been found to have the poorest outcome after undergoing PRK as well, the authors said.

“Postmenopausal women on HRT had a poorer outcome than younger premenopausal women,” the researchers said. They recommended a prospective study to determine if a relationship truly exists.

The study is published in the April issue of Journal of Refractive Surgery.