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LASIK in Patient with Active Uveitis
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LASIK in Patient with Active Uveitis

I am a 29-year-old with idopathic bilaterial anterior uveitis.  I was diagnosed when I went to the optometrist for a routine exam to have my contact lens prescription renewed, and had been completely asymptomatic.  I had no prior history of uveitis and all tests for associated underlying autoimmune disorders were thankfully negative. The ophthalmologist put me on Pred Forte and tapered me off of it over the course of about 3 weeks.  The inflammation cleared up quickly, and my eyes remained clear until I was taken off the Pred Forte completely, at which point it returned, although at a much lower level than when I was initially diagnosed.  He then put me back on the Pred Forte and tapered me off again, this time much more slowly, over the course of about 3 months.  Same results as before - the inflammation cleared up almost immediately when I went back on the steroid and remained clear throughout the taper, until we stopped the Pred Forte completely.  After that, he decided to put me back on the Pred Forte, veeeery slowly taper me down to 1 drop per day, and to keep me at that level for the foreseeable future.  As it stands, I have been on 1 drop/day of Pred Forte for about 4 months now, with no end in sight.

My question is regarding laser vision correction.  Faced with the prospect of being on Pred Forte and not being able to wear my contact lenses for an extended period of time, I would like to have my vision corrected surgically.  I was wondering if this would be possible.  Would I have to be off the Pred Forte in order to have the surgery?  I assume I would, and my thinking is that it would be possible to take me off of the Pred Forte and then have the surgery, and then go back on the steroid to re-treat the uveitis afterwards.  Since I responded to the steroid so well previously, I see no reason I would fail to respond after surgery, and since I never had any symptoms (despite being grade 3+ in both eyes at the time of diagnosis), I'm willing to deal with another flare-up.  I guess my question is, would my eyes have to be clear at the time of surgery?  I imagine that the inflammation will return once I am taken off the Pred Forte - if so, will that prevent me from being able to have the surgery?  Or could the surgery be performed even if I had some low level of inflammation, assuming we would resume the Pred Forte to control the uveitis afterwards?  Or do I have to go off the Pred Forte, hope it doesn't flare back up, and schedule the surgery if my eyes manage to stay clear for X amount of time?  I should mention that after coming off the Pred Forte, when the uveitis returned, it was grade 1 or less, so if it does flare up again, it wouldn't be a high level of inflammation, if that makes a difference.  My eyes are otherwise healthy, my IOPs are well within the normal range, and I have no history of any other eye or vision problems.  Also, I don't know if this makes a difference either, but my prescription is -1.0 in one eye and -1.25 in the other and I have no astigmitism, so I imagine the vision correction itself would be fairly simple.  

So the question is, would LASIK be a viable option for me, or should I suck it up and resign myself to wearing my glasses forever?  :-)  Any thoughts you have would be greatly appreciated!!  
Tags: LASIK, uveitis
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233488_tn?1310696703
Each refractive Eye MD ophthalmologist would have to make their own determination.

We would probably put you on low grade steroid (ie lotemax or FML) for 4-6 months monitoring carefullly for flare up then taper you off. If it reoccured then we might send you to a rheumatologist to see if they could find an overlooked underlying cause.

If you went 3-6 months with no flare up then you might be considered for lasik

JCH MD
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