Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa

Majid Moshirfar,1– 3 Victoria M Wang,4 Kayvon A Moin,1 Phillip C Hoopes Snr1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Department of Ophthalmology, Utah Lions Eye Bank, Murray, UT, USA;...

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Main Authors: Moshirfar M, Wang VM, Moin KA, Hoopes Snr PC
Format: Article
Language:English
Published: Dove Medical Press 2024-12-01
Series:Clinical Ophthalmology
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Online Access:https://www.dovepress.com/corneal-refractive-surgery-considerations-in-patients-with-anorexia-ne-peer-reviewed-fulltext-article-OPTH
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author Moshirfar M
Wang VM
Moin KA
Hoopes Snr PC
author_facet Moshirfar M
Wang VM
Moin KA
Hoopes Snr PC
author_sort Moshirfar M
collection DOAJ
description Majid Moshirfar,1– 3 Victoria M Wang,4 Kayvon A Moin,1 Phillip C Hoopes Snr1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Department of Ophthalmology, Utah Lions Eye Bank, Murray, UT, USA; 4Department of Ophthalmology, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USACorrespondence: Majid Moshirfar, Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA, Tel +1 801-568-0200, Fax +1 801-563-0200, Email cornea2020@me.comAbstract: Anorexia nervosa (AN) is a psychiatric eating disorder characterized by body mass index (BMI) ≤ 18.5, fear of gaining weight, and a distorted perception of body weight. With increasing rates of myopia, there is a population of patients who concurrently develop AN and may seek corneal refractive surgery. This study reviews the ophthalmic manifestations of AN and provides preliminary guidelines for patients with AN undergoing corneal refractive surgery. The literature search was conducted through the PubMed, Scopus, and Ovid databases through June 2, 2024, for publications detailing the ocular manifestations of AN. These findings were then considered in the context of potential complications after corneal refractive surgery, and preoperative guidelines for patients with AN were formulated. Twelve articles described a total of 114 patients with AN (227 eyes) with ophthalmic manifestations. Among the studied eyes, 14% had ocular surface abnormalities, 5% had cataracts/visual disturbances, 64% had posterior segment abnormalities, and 20% had orbital/neurological abnormalities. Various ophthalmic findings of AN may increase the risk of delayed corneal wound healing, ocular surface dryness, perioperative bleeding, flap-related complications, and poor visual outcomes after corneal refractive surgery. The BMI of patients suspected with AN must be assessed, and patients should be screened for diagnosis of AN. If mildly and moderately underweight patients with AN have normal ophthalmic and medical workups, they may proceed with a typical preoperative workup for corneal refractive surgery. Ultimately, the decision to recommend elective corneal refractive surgery for these patients rests with the surgeon. This study should be considered a foundation for future research, encouraging collaboration across medical disciplines to develop more comprehensive guidelines for managing this patient population.Keywords: ophthalmic manifestation, guidelines, eating disorder, LASIK, PRK, SMILE
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spelling doaj-art-30dba75c3dfc4700a439a3e970849a302024-12-26T16:44:16ZengDove Medical PressClinical Ophthalmology1177-54832024-12-01Volume 183925393498726Corneal Refractive Surgery Considerations in Patients with Anorexia NervosaMoshirfar MWang VMMoin KAHoopes Snr PCMajid Moshirfar,1– 3 Victoria M Wang,4 Kayvon A Moin,1 Phillip C Hoopes Snr1 1Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA; 2John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Department of Ophthalmology, Utah Lions Eye Bank, Murray, UT, USA; 4Department of Ophthalmology, University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USACorrespondence: Majid Moshirfar, Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA, Tel +1 801-568-0200, Fax +1 801-563-0200, Email cornea2020@me.comAbstract: Anorexia nervosa (AN) is a psychiatric eating disorder characterized by body mass index (BMI) ≤ 18.5, fear of gaining weight, and a distorted perception of body weight. With increasing rates of myopia, there is a population of patients who concurrently develop AN and may seek corneal refractive surgery. This study reviews the ophthalmic manifestations of AN and provides preliminary guidelines for patients with AN undergoing corneal refractive surgery. The literature search was conducted through the PubMed, Scopus, and Ovid databases through June 2, 2024, for publications detailing the ocular manifestations of AN. These findings were then considered in the context of potential complications after corneal refractive surgery, and preoperative guidelines for patients with AN were formulated. Twelve articles described a total of 114 patients with AN (227 eyes) with ophthalmic manifestations. Among the studied eyes, 14% had ocular surface abnormalities, 5% had cataracts/visual disturbances, 64% had posterior segment abnormalities, and 20% had orbital/neurological abnormalities. Various ophthalmic findings of AN may increase the risk of delayed corneal wound healing, ocular surface dryness, perioperative bleeding, flap-related complications, and poor visual outcomes after corneal refractive surgery. The BMI of patients suspected with AN must be assessed, and patients should be screened for diagnosis of AN. If mildly and moderately underweight patients with AN have normal ophthalmic and medical workups, they may proceed with a typical preoperative workup for corneal refractive surgery. Ultimately, the decision to recommend elective corneal refractive surgery for these patients rests with the surgeon. This study should be considered a foundation for future research, encouraging collaboration across medical disciplines to develop more comprehensive guidelines for managing this patient population.Keywords: ophthalmic manifestation, guidelines, eating disorder, LASIK, PRK, SMILEhttps://www.dovepress.com/corneal-refractive-surgery-considerations-in-patients-with-anorexia-ne-peer-reviewed-fulltext-article-OPTHophthalmic manifestationguidelineseating disorderlasikprksmile
spellingShingle Moshirfar M
Wang VM
Moin KA
Hoopes Snr PC
Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
Clinical Ophthalmology
ophthalmic manifestation
guidelines
eating disorder
lasik
prk
smile
title Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
title_full Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
title_fullStr Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
title_full_unstemmed Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
title_short Corneal Refractive Surgery Considerations in Patients with Anorexia Nervosa
title_sort corneal refractive surgery considerations in patients with anorexia nervosa
topic ophthalmic manifestation
guidelines
eating disorder
lasik
prk
smile
url https://www.dovepress.com/corneal-refractive-surgery-considerations-in-patients-with-anorexia-ne-peer-reviewed-fulltext-article-OPTH
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