http://www.osnsupersite.com/default.asp?ID=12059

Common acne drug contraindicated after LASIK, as well as before

Isotretinoin, a topical medication commonly prescribed for acne, should be contraindicated for patients after LASIK surgery, a recent commentary in a dermatology publication suggests.

Just as patients should stop using the acne medication at least 6 months before LASIK surgery, they also should not be given the medication for 6 months after surgery, the authors of the commentary said.

In the January issue of the Journal of the American Academy of Dermatology, Stacia Miles, MD, and colleagues at the University of Missouri, Columbia, note that Accutane (isotretinoin, Roche) is prescribed for about 2 million people per year. The average age of these patients is 24 years, and many patients undergoing LASIK are between 18 and 30 years old, so the two patient populations overlap, the authors note.

“Given that isotretinoin can also cause dry eye, it is a contraindication to perform LASIK on a patient taking isotretinoin,” they said.

In a survey of 50 ophthalmologists, the authors found that 100% screened for isotretinoin use in potential LASIK candidates. But in a similar survey of 50 dermatologists, they found that none of them screened specifically for recent LASIK surgery.

The authors quote ophthalmologist John W. Cowden, MD, also of the University of Missouri, Columbia, as saying “there is a critical period of healing following a LASIK procedure that would be compromised by the initiation of medication such as isotretinoin.”

Dr. Cowden noted that although it is the ophthalmologist’s job to screen potential surgical candidates for isotretinoin use, they cannot prevent their patients from starting isotretinoin after LASIK is completed.