Carter S Tisdale1, Grant A Justin2, Xun Wang3, Xiuping Chu3, Darrel K Carlton4, Jason F Okulicz5, Christina Schofield6, Ryan C Maves7, Brian K Agan3, Gary L Legault4. 1. 563rd Operations Support Squadron, Nellis Air Force Base, Las Vegas, Nevada, USA. 2. Department of Ophthalmology, Brooke Army Medical Center, San Antonio, Texas, USA; Department of Surgery, Uniformed Services University of the Health Science, Bethesda, Maryland, USA. Electronic address: grant.a.justin@gmail.com. 3. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA. 4. Department of Ophthalmology, Brooke Army Medical Center, San Antonio, Texas, USA; Department of Surgery, Uniformed Services University of the Health Science, Bethesda, Maryland, USA. 5. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA; Infectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. 6. Division of Infectious Diseases, Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, USA. 7. Division of Infectious Diseases (Maves), Naval Medical Center San Diego, California, USA.
Abstract
PURPOSE: This study sought to assess the frequency of refractive surgery complications in HIV+ individuals and related risk factors. SETTINGS: Multiple centers in the United States. DESIGN: Prospective observational cohort study. METHODS: The U.S. Military HIV Natural History Study is a prospective observational cohort study of HIV+ service members and beneficiaries. Participants were selected who had Current Procedural Terminology codes for laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and other refractive surgeries. The frequency of complications was determined using International Classification of Diseases-9 codes. Covariates included age, sex, antiretroviral therapy, time since HIV diagnosis, history of AIDS, and CD4 (T lymphocytes) count and viral load. Statistical analysis was completed using univariate (χ2 and Wilcoxon-Mann-Whitney tests) and multivariate analyses. RESULTS: Seventy-nine of 2073 participants had refractive surgery. Fifty-three patients underwent PRK, 23 LASIK, 2 radial keratotomy (RK), and 1 astigmatic correction. Complications occurred in 6 (7.6%) of 79 participants, including 5 patients who underwent PRK and 1 after RK, occurring between 8 and 217 days after surgery. Five ulcers and 1 unspecified keratitis were noted. In the univariate analysis, type of surgery (P = .02) and history of AIDS (P = .02) were risk factors for complications. In logistic regression analysis, no variables were found to be risk factors for complications. CONCLUSION: Complications were infrequent among HIV+ participants after refractive surgery. Point estimates suggest that PRK might have more complications than LASIK and that advanced HIV, reflected by previous AIDS, might be associated with an increased risk for complications. Further study will be required to confirm these findings. Published by Elsevier Inc.
PURPOSE: This study sought to assess the frequency of refractive surgery complications in HIV+ individuals and related risk factors. SETTINGS: Multiple centers in the United States. DESIGN: Prospective observational cohort study. METHODS: The U.S. Military HIV Natural History Study is a prospective observational cohort study of HIV+ service members and beneficiaries. Participants were selected who had Current Procedural Terminology codes for laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and other refractive surgeries. The frequency of complications was determined using International Classification of Diseases-9 codes. Covariates included age, sex, antiretroviral therapy, time since HIV diagnosis, history of AIDS, and CD4 (T lymphocytes) count and viral load. Statistical analysis was completed using univariate (χ2 and Wilcoxon-Mann-Whitney tests) and multivariate analyses. RESULTS: Seventy-nine of 2073 participants had refractive surgery. Fifty-three patients underwent PRK, 23 LASIK, 2 radial keratotomy (RK), and 1 astigmatic correction. Complications occurred in 6 (7.6%) of 79 participants, including 5 patients who underwent PRK and 1 after RK, occurring between 8 and 217 days after surgery. Five ulcers and 1 unspecifiedkeratitis were noted. In the univariate analysis, type of surgery (P = .02) and history of AIDS (P = .02) were risk factors for complications. In logistic regression analysis, no variables were found to be risk factors for complications. CONCLUSION: Complications were infrequent among HIV+ participants after refractive surgery. Point estimates suggest that PRK might have more complications than LASIK and that advanced HIV, reflected by previous AIDS, might be associated with an increased risk for complications. Further study will be required to confirm these findings. Published by Elsevier Inc.
Authors: Fernando Llovet; Victoria de Rojas; Emanuela Interlandi; Clara Martín; Rosario Cobo-Soriano; Julio Ortega-Usobiaga; Julio Baviera Journal: Ophthalmology Date: 2009-12-14 Impact factor: 12.079
Authors: Steven P Davison; Neil R Reisman; Edmund D Pellegrino; Ethan E Larson; Meghan Dermody; Paul J Hutchison Journal: Plast Reconstr Surg Date: 2008-05 Impact factor: 4.730
Authors: Vincent C Marconi; Greg A Grandits; Amy C Weintrob; Helen Chun; Michael L Landrum; Anuradha Ganesan; Jason F Okulicz; Nancy Crum-Cianflone; Robert J O'Connell; Alan Lifson; Glenn W Wortmann; Brian K Agan Journal: AIDS Res Ther Date: 2010-05-27 Impact factor: 2.250
Authors: Jodie L Guest; Amy C Weintrob; David Rimland; Christopher Rentsch; William P Bradley; Brian K Agan; Vincent C Marconi Journal: PLoS One Date: 2013-05-01 Impact factor: 3.240