Millions of people have gotten LASIK surgery to improve their eyesight. But is LASIK a safe choice for someone with diabetes? We recently asked Dr. Thomas Marvelli, an ophthalmologist based in Fort Worth, Texas, about how he counsels his patients diabetes. Here was his response:
Medical research has identified a clear link between diabetes and ocular or eye-related complications. Those who have diabetes are at a higher risk of facing eye complications in the future. Further, some effects of diabetes, like slow healing and increased risk of infections, makes eye-related procedures, including LASIK, a potentially risky affair for patients with diabetes.
The US FDA treats diabetes as a relative contraindication to LASIK for the following reasons:
- Unstable and varying need for glasses for diabetic patients.
- Weakened immune function.
- Delayed or poor healing, and
- Potential risk of operative and post-operative complications like retinal blood vessel issues.
People with diabetes can opt for LASIK; they are simply advised to proceed ahead after a thorough and detailed analysis of the potential risks and consequent benefits. While studies have shown a clear link between diabetes and eye-related problems, researches focusing on LASIK have yielded mixed results, which indicate that the relative contraindication may just be the result of a conservative and safety-first approach.
People with diabetes can opt for LASIK without enhanced risk of postoperative complications provided their blood-sugar levels are under control. Merely having the right readings on the day of the LASIK surgery will not be enough. The final decision should be based on their A1C test readings.
Hemoglobin, which is found in red blood cells, reacts with excess blood sugar and becomes glycated. Since red blood cells have a lifespan of around three months, the glycated hemoglobin test indicates the extent of blood sugar control over a period of two to three months.
People without diabetes should have an A1C result between 4% and 5.6%. Those with gylcated hemoglobin count in excess of 6.5% are said to have diabetes. The risks involved in undergoing the LASIK surgery outweigh the potential benefits if the patient’s A1C result is in excess of 7%. A reading of 7% or below reduces the risk of post-operative complications arising out of diabetes.
In case of the individual having uncontrolled diabetes, then primary efforts should focus on bringing blood sugar levels under control. Again, merely bringing the daily blood sugar count under control will not suffice. The risks involved in undergoing a procedure like LASIK will come down only when blood sugar levels are kept under control for a period of two to three months.
Apart from diabetes medications, you could benefit by switching to a healthier lifestyle to ensure your diabetes remains under control at all times. Smaller and more frequent meals, intake of complex carbohydrates, and following a regular and disciplined exercise regimen will ensure faster control over diabetes.
The A1C result should fall below 7% in a sustainable manner. The eyes will need some time to heal after the LASIK surgery. A surge in blood sugar levels after the procedure can enhance the chances of complications. Hence, the person with diabetes should ensure he or she follows a healthy lifestyle before and after the procedure.
It is a myth that those with diabetes are bound to suffer complications after undergoing LASIK surgery. While uncontrolled diabetes can lead to problems, keeping your blood sugar levels under control through sustained and disciplined efforts will increase chances of a safe and complication-free surgery.
Have you had LASIK surgery with diabetes? Please share your experience in the comments below.
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