Abstract

Importance: To discuss a new post-operative (post-op) protocol for patients undergoing laser-assisted in situ keratomileusis (LASIK) seen during the COVID-19 pandemic.

Background: With advances in analytic software for topography-guided LASIK, better visual outcomes and lower rates of post-op complication and the need for enhancement surgery have allowed for safe yet effective ways to manage patients before, during, and after surgery. However, with the present state of practicing in a pandemic the authors propose a new practice pattern to promote efficiency, maintain outcomes, and potentially reduce ophthalmic complications while keeping our patients safe.

Design: A insignificant risk retrospective review of topography-guided LASIK using two separate protocols. The authors used one prior to the pandemic and another during the pandemic with new patient safety guidelines. Comparison of outcomes will be discussed.

Participants: A total of 1,026 eyes from 513 patients were treated with LASIK prior to the pandemic and during the time of COVID-19 were included in the patient population.

Methods: Management of patients with current post- op protocol including in-patient visits at preoperative, one day, one week, one month, three months and twelve months compared with a new protocol including in-patient visits at preoperative, post op one day, three months and twelve months but telehealth visits with subjective questionnaire at one week and one month were utilized during the pandemic as well as patient isolation from other patients were also instituted preoperatively and postoperatively during the pandemic.

Main Outcome Measures: Results included uncorrected visual acuity (UCVA) outcomes for patients in each group as well as total enhancement rates.

Results: No significant differences were seen between UCVA outcomes between groups. The rate of enhancement was also insignificant. Postoperative day 1 UCVA 20/20 or better in individual eyes (OD/OS) was 97% vs 99% in Pre-COVID-19 vs Post-COVID-19 respectively. Postoperative day 1 UCVA 20/15 or better in both eyes (OU) was 81% vs 84%. The enhancement rate at one year in each group was identical at 0.29%.

Conclusion: The application of advanced analytic computer software engine allows for better planning of LASIK and provides an opportunity for a more efficient and safe protocol for management of patients. Reduction in overall diagnostics and the use of telemedicine also provided benefits to patients and similar outcomes, as compared to prior to the pandemic. No patients during the treatment period developed COVID-19 to our knowledge.

Keywords: Laser-assisted In Situ Keratomileusis (LASIK); COVID-19; Telehealth; Telemedicine; Post-operative (post-op) Management; Uncorrected Visual Acuity (UCVA)

References

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Citation

Citation: Karl Stonecipher., et al. “Management of Post-operative LASIK Patients Before and After COVID-19: New Treatment Protocols".Acta Scientific Ophthalmology 4.11 (2021): 47-52.

Copyright

Copyright: © 2021 Karl Stonecipher., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.