Why is laser eye surgery not recommended for people with rheumatoid arthritis?
Q) I was interested in your reply to a letter about the problems that rheumatoid arthritis patients experience with regards to laser eye treatment in the Autumn 2009 edition of Arthritis Today. I understand that a very common outcome of these treatments is that patients without any pre-existing conditions suffer from dry-eye syndrome after treatment, even when the vision correction has been successful. Given that dry eyes are a very common problem associated with rheumatoid arthritis, I wonder if this would be a reason that ophthalmic surgeons are reluctant to carry out laser treatment on people with rheumatoid arthritis – not wishing to escalate the problems that the patient may already be battling with?
Peter Legge, Trowbridge, Wiltshire (Winter 2009)
A) It's said that any dryness resulting from this procedure is only temporary, although there's a small risk of more permanent dryness. I understand that the problem with diseases such as rheumatoid arthritis is that healing of the corneal flap may be impaired. What is the corneal flap? To do the surgery a small flap of tissue is removed from the front of the eye to allow the laser treatment to be performed. This flap is replaced after the laser surgery so that there's a wound on the eyeball which has then to heal. It's this healing process that surgeons are concerned may be delayed or even abnormal in conditions such as rheumatoid arthritis.