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Humidity level in OR influences LASIK outcomes

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THOROFARE, N.J. — High humidity in the operating room during the warm summer months may increase the need for enhancements after LASIK, according to Keith A. Walter, MD. To compensate, he suggests adjusting LASIK nomograms to account for differing levels of humidity in the operating room.

Dr. Walter said he noticed that most of his enhancements are performed on patients who underwent LASIK surgery in his North Carolina practice during July, August and September.

“After a few years of noticing this pattern, I conducted a study on the possible environmental factors that may inhibit successful LASIK outcomes,” he told Ocular Surgery News. Dr. Walter and colleagues at Wake Forest University found a significant correlation between the rise in temperature and humidity and the increased need for LASIK enhancements.

A higher water concentration in the indoor and outdoor environment may inhibit or reduce the amount of laser energy absorbed by the cornea, as well as force the cornea to retain more moisture, Dr. Walter said.

His study retrospectively reviewed 368 eyes of 191 myopic patients who underwent LASIK during 2000. All patients underwent a 1-year follow-up visit that documented their LASIK outcomes, including complications, correction errors and enhancement procedures.

Researchers found that 57 of the 368 eyes needed enhancement; 50 were undercorrected and seven were overcorrected. Enhancements were done an average of 7.25 months after LASIK. Most patients with undercorrections had undergone the initial LASIK surgery in the summer.

“We really noticed a major spike in enhancements during the summer months. Again, by November and December, the enhancement rate was down to almost zero,” Dr. Walter said. “Logistic regression analysis found that the operating room relative humidity was the single most important factor in unsuccessful LASIK outcomes. We had a very high probability value for room humidity. We got P = .003, with an odds ratio of 1.093.”

For more details on Dr. Walter's study and the effects of humidity on LASIK outcomes, see the upcoming August 1 print edition of Ocular Surgery News.