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Ineligibility for laser refractive surgery: reasons and alternatives

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First Author: I.Piotrowiak-Słupska POLAND

Co Author(s):    D. Kalwa   I. Jaworowska-Cieślińska   B. Kałużny              

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Laser refractive surgery is a method of rising popularity. Modern techniques enable correction of larger range of error with minimal risk of complications. The majority of candidates are accepted for the procedure and obtain satisfactory refractive and functional results. However, some patients are not eligible for this method of correction.


Oftalmika Eye Clinic Bydgoszcz, Poland


In 2015-2019 in Oftalmika Eye Clinic in Bydgoszcz 3031 patients (5942 eyes) underwent qualification visit for laser refractive surgery. 1375 eyes (23.14%) proved ineligible, 680 patients bilaterally, 15 patients unilaterally. We conducted a retrospective analysis of reasons of ineligibility and alternative methods of vision correction offered to these patients.


Reasons of ineligibility were due to refractive error (29.96%), measurements during qualification (33.67%), concomitant eye disorders (21.38%), concomitant general disorders (3.39%) and patients’ unrealistic expectations (11.05%). Alternative methods included contact lenses, orthokeratology, monocular glasses, multifocal glasses, refractive lens exchange, cataract facoemulsification with intraocular lens implantation, Implantable Collamer Lens implantation, and corneal cross-linking.


Wide range of possibilities to precisely predict postoperative results, including side effects in patients with rising expectations should encourage ophthalmologists to thorough analysis of every patient due to their needs. In some cases better results can be obtained with postponed surgery. Alternative methods of vision correction should also be considered, especially in patients with strong surgical anxiety.

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