Optimize LASIK outcomes by setting patient expectations and learning from surgeries
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Some patients with certain underlying conditions, such as depression or dry eye disease, may be dissatisfied with their LASIK results unless these conditions are addressed and realistic expectations are set preoperatively, a speaker said.
While 95% to 99% of patients are satisfied with their LASIK outcomes, 1% to 5% of patients are not, and it is “very important” to address concerns before surgery, Priyanka Sood, MD, said at the virtual OSN New York meeting.
“I spend that extra time setting appropriate expectations because I’d rather forego surgery than have an unhappy patient in my chair,” she said.
When setting expectations, patients should be informed of the possibility that they may need post-LASIK enhancement within a year, but because of postoperative healing and remodeling, enhancements would not be scheduled until after the first 3 months postop.
Patients with depression may have unrealistic expectations and should be counseled preoperatively to determine whether surgery should be delayed, Sood said.
Dry eye, which is common in patients who wear contact lenses, should be addressed preoperatively as well. If a patient experiences dry eye symptoms while wearing glasses, PRK may be more appropriate than LASIK, but if dry eye symptoms improve with glasses, LASIK is likely still appropriate, Sood said.
Patients should be informed that new onset of dry eye symptoms postoperatively is not uncommon. These should be addressed quickly with preservative-free artificial tears, punctal plugs or medication.
Surgeons can also improve their own performance by evaluating outcomes of their prior LASIK procedures.
“Learn from your surgeries. Look at your outcomes and assess why you didn’t hit your target. Make one change at a time and focus on your nomograms so you can constantly improve your outcomes,” she said.
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Sood P. Optimizing LASIK outcomes. . Presented at: OSN New York and OSN New York Retina; Oct. 17-18, 2020 (virtual meeting).
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