Outcomes Of Laser Vision Correction With Diabetes Meletus: A Retrospective Real-World Study
Published 2026 - 44th Congress of the ESCRS
Reference: FP27.02 | Type: Free paper | DOI: 10.82333/gcs2-ts82
Authors: Dr Dror Ben Ephraim Noyman* 1 , Mr Tzahi Sela 2 , Mr Gur Munzer 2 , Prof. Igor Kaiserman 3 , Prof. Michael Mimouni 1 , Dr Adir Sommer 1 , Dr Artemis Matsou 4 , Dr Eyal Cohen 5
1Ophthalmology,Rambam Health Care Campus,Haifa,Israel, 2Care-Vision Laser Center,Tel Aviv,Israel, 3Ophthalmology,Barzilai Medical Center,Ashkelon,Israel, 4Corneoplastic Unit,Queen Victoria Hospital,East Grinstead,United Kingdom, 5Ophthalmology,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel
Purpose
Diabetes mellitus (DM) is common and can alter corneal wound healing, tear-film stability, and neurosensory function, potentially impacting visual recovery and refractive accuracy after laser vision correction. Evidence guiding procedure choice in DM remains limited and heterogeneous, and many centers treat DM as a relative contraindication or modify perioperative protocols. We aimed to evaluate real-world visual and refractive outcomes of photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) in adults with controlled DM as compared to the general population for correction of hyperopia and myopia., and to compare the two surgical techniques within DM patients.
Setting
Retrospective Study, Care-Vision Laser Center, Tel Aviv, Israel
Methods
This retrospective comparative study included consecutive myopic and hyperopic adults with either controlled DM or no known chronic systemic disease, all aimed for emmetropia, without ocular comorbidities or prior ocular surgery, who underwent PRK or LASIK between 2013 and 2024. Baseline characteristics were balanced using propensity score matching. Refractive and visual outcomes were assessed between diabetic and control groups for each modality, and between PRK and LASIK within the diabetic cohort.
Results
After matching, 794 eyes (DM 161; controls 633) were analyzed for myopic PRK; 186 eyes (DM 97; controls 373) for myopic LASIK; and 113 diabetic myopic eyes (PRK 75; LASIK 38) for within-population modality differences. 557 eyes (DM 29; controls 528) were assessed for hyperopic LASIK correction. For myopia- there were no significant differences between DM and control groups in PRK outcomes. In LASIK, efficacy was lower in DM than controls (0.96 vs 1.00; p=0.048) with non-inferior safety (1.01 vs 1.03; p=0.129) and no other significant differences. Within the diabetic population, PRK demonstrated significantly higher efficacy than LASIK (1.00 vs 0.90; p=0.035). For hyperopia – LASIK demonstrated no significant differences between the groups.
Conclusions
Safety was comparable in myopic diabetics, however PRK showed superior efficacy to LASIK and achieved efficacy and safety similar to healthy controls. Subject to other clinical considerations, PRK should be considered as the preferred option for myopic DM patients upon counseling on procedure choice.