Answer: A person with MS should not be precluded from Lasik surgery (or PRK surgery) simply because they have MS, but I would recommend a thorough Neuro-ophthalmolodical evaluation before this surgery is considered. The most important issues to consider prior to corrective surgery are the following:
- The degree of refraction required. Large amounts of correction required for either near or farsightedness are going to result in a less successful outcome from surgery
- The thickness of the cornea or any other ocular condition that could be negatively impacted by surgery.
- Whether or not you have dryness of the eyes; this makes an individual more prone to infection and scaring after surgery. Dry eyes is fairly common in MS patients, often due to medications.
- Whether or not the vision problems are actually caused by a problem with refraction. Any visual field problems from MS or problems involving the optic nerve or retina will not be improved by surgical correction. Cataracts are also fairly common at an early age in MS patients (usually from multiple steroid treatments) and would be a contraindication for lasik surgery.
The one thing that would not prevent you from having lasik surgery is treatment with any of the disease modifying therapies for MS. The exceptions to this rule would recent treatment with chemotherapy (cyclophosphamide and mitoxantrone) and steroids (solumedrol, methylprednisolone, prednisone); I would recommend being off chemotherapy and steroids for at least 6 months before considering lasik surgery.
I would check this advice with the ophthalmologist who will be doing the lasik surgery as well as your neurologist to make sure there are no special considerations in your case.
Rip Kinkel, MD
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