Impact of Oral A-Retinoic Acid on LASIK Surgery and Dry Eyes

Oral isotretinoin and issues related to myopia laser surgery?

Hello doctor, I started taking oral isotretinoin at the beginning of November, and I plan to undergo laser surgery for my myopia in early February next year.
I would like to know if the dry eye side effects from the medication will affect the evaluation for the laser surgery or the postoperative recovery.
Should I stop taking oral isotretinoin before the surgery? I have read that it is recommended to stop the medication for six months prior to surgery.
I am uncertain about this and wonder if I should refrain from taking oral isotretinoin until after the laser surgery.

A-Jie, 20~29 year old female. Ask Date: 2017/11/22

Dr. Wu Yuxin reply Dermatology

I am not sure if it will affect the ophthalmic surgery; it is advisable to consult an ophthalmologist first.

Reply Date: 2017/11/22

More Info

The use of oral A-Retinoic Acid (commonly known as Accutane) can have significant implications for individuals considering LASIK surgery, particularly concerning dry eye symptoms. Accutane is known to cause dryness in various mucous membranes, including the eyes, which can lead to or exacerbate existing dry eye conditions. This is particularly relevant for LASIK candidates, as the surgery itself can also induce temporary dry eye symptoms post-operatively.

When considering LASIK surgery, it is crucial to have stable tear production and a healthy ocular surface. The presence of dry eyes can affect both the pre-operative evaluation and the post-operative recovery. If you are experiencing dry eye symptoms due to Accutane, it may complicate the assessment of your candidacy for LASIK. Surgeons typically evaluate the tear film and ocular surface health before proceeding with surgery, and significant dry eye symptoms could lead to a recommendation to delay the procedure until the condition is managed.

Regarding your question about whether to stop taking Accutane before LASIK, it is generally advisable to discontinue the medication for a period before the surgery. Many eye care professionals recommend stopping Accutane at least six months prior to LASIK to allow the ocular surface to recover and stabilize. This timeframe helps ensure that any dry eye symptoms induced by the medication have subsided, allowing for a more accurate assessment of your eye health and a better surgical outcome.

If you are currently experiencing significant dry eye symptoms, it may be beneficial to consult with an ophthalmologist or a cornea specialist. They can provide tailored advice based on your specific situation, including potential treatments for dry eyes, such as artificial tears, punctal plugs, or other therapies that can help improve your ocular surface health before undergoing LASIK.

In summary, while Accutane can be effective for treating certain skin conditions, its side effects on eye health, particularly dry eyes, can pose challenges for LASIK candidates. It is essential to communicate openly with your eye care provider about your medication history and any symptoms you are experiencing. They will guide you on the best course of action, including whether to pause Accutane and how to manage dry eye symptoms effectively before your planned LASIK surgery. Prioritizing eye health will ultimately contribute to a more successful surgical outcome and recovery.

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