Way OT-Breastfeeding and Lasik surgery?

[allyphoe]

Visit FDA.gov/cdrh/LASIK/ where you will see that pregnancy and lactation are specific contraindications for Lasik.

I don't doubt that for a moment. There's absolutely no upside (and considerable potential downside) for either the laser manufacturers or the FDA in testing any cosmetic procedure on the tiny fraction of women who practice extended breastfeeding.

Long-term fluctuation of retinal sensitivity during pregnancy.
Urokinase-type plasminogen activator to prevent haze after photorefractive keratectomy, and pregnancy as a risk factor for haze in rabbits.
Regression of myopia induced by pregnancy after photorefractive keratectomy.

Ah, but we aren't talking about pregnancy. We're talking about nursing a baby more than a year old.

Relation of hormone and menopausal status to outcomes following excimer laser photorefractive keratectomy in women.

Now that one looked promising. Unfortunately, the hormones they looked at were HRT in postmenopausal women. So we're back to pregnancy again, with no mention of breastfeeding.

Research on the connection between vision changes and pregnancy/lacation goes back decades.

Pregnancy isn't relevant to this discussion; no one is suggesting that pregnant women have Lasik. I agree that both pregnancy and early lactation can have an effect on vision in some (heck, I'd give you "many," although AFAICT from the small studies available, it's about 25%) women.

The question is whether there is any scientific basis for believing that a woman nursing a toddler or preschooler, whose hormone profile is indistinguishable from a non-lactating woman (and who may not actually be producing any milk whatsoever), and who has experienced neither pregnancy-related nor lactation-related vision changes, should expect a worse outcome from LASIK than an identical woman who isn't nursing.

If knowing the answer happened to be worth $39 to anyone, the place I'd start would be http://www.blackwell-synergy.com/doi/abs/10.1111/j.1479-828X.2006.00569.x. The abstract reads: "Pregnancy is known to cause refractive changes as a result of various hormonal changes occurring during pregnancy. These changes may persist for a few weeks post-partum and during lactation. In this article we discuss various refractive issues in pregnancy that have an effect on contact lens use, myopia and the outcome of refractive surgery."

Now that I'm home (rather than at work), and have had a chance to browse around PubMed (I didn't have enough eye-related technical vocabulary to get good results; the cites you provided were very helpful in that regard), I see nothing on point. Including, interestingly enough, any research into the mechanism by which eyes change during pregnancy; the unsubstantiated claims seem to split 75:25 on unspecified "hormones" (which we seem to be assuming means prolactin) vs. blood volume / pressure changes.

In any case, if it's prolactin triggering the changes, I stand by my conclusion that a nursing mother with a >2yo child almost certainly has no different serum prolactin levels than a non-nursing woman. So if there is a legitimate scientific basis for believing she'd be a poor candidate for LASIK for no reason other than nursing, prolactin isn't the deciding factor.

 

[allyphoe]

Sorry to follow up on myself, but I just came across this:

http://www.eyesurgeryinstitute.com/faq.html

If I am pregnant, can I undergo LASIK?
Dr. Grandon would not perform LASIK on a pregnant woman, primarily because her refraction can change slightly during pregnancy, making it more difficult to achieve the desired correction. Also, the eye drop medications needed in the first three months after LASIK may be contraindicated. However, a woman can undergo LASIK when she is breast-feeding.

Ooh, and http://www.revoptom.com/index.asp?page=2_537.htm has an unsupported claim that it's fluctuating estrogen levels, which is consistent with the finding that postmenopausal women on HRT are poor PRK candidates (but not with the fact the birth control pills aren't a contraindication). In any case, if you're having ovulatory menstrual cycles, your estrogen levels aren't fluctuating any more (or less) than any non-breastfeeding woman. (And if you've managed to hold off AF more than a year or two by breastfeeding, that should be reward enough for you!)

Ah, some days I wish I'd liked science more in school. Labs were the bane of my existence, though. (My degree is in psych, with a research concentration. People are more fun than petri dishes.)​

 

[LasikExpert]

It is common for medical findings to be "old", but there are always new doctors and researchers working to verify what is known and learn what is not. I have found the best source for peer-reviewed medical information is through PubMed.com. They have a very good searchable database.

I am the founder of the Council for Refractive Surgery Quality Assurance, a nonprofit, nongovernmental organization that evaluates and certifies doctors who provide Lasik surgery. On our website USAEyes.org we provide researched information about Lasik and similar vision correction surgery issues. If you go to the "About" section you will find the history of our organization. If you go to the Quality Standards Advisory Committee link from the About section you will find a short professional biography. I'd provide you with direct links, however this forum has restrictions on new users.

Glenn Hagele
USAEyes

I am not a doctor.