CORRECTIVE LASIK EYE SURGERY FOR EHLERS-DANLOS SYNDROME

Before we dive into the essentials of the corrective LASIK eye surgery to treat the Ehlers-Danlos syndrome, let us attempt to form an overview of this dysfunction. The Ehlers-Danlos syndrome is principally a set of distinct disorders that affect the bones, blood vessels, skin, and several other organs and tissues. Evidently, shortcomings in connective tissues open doors to the symptoms of these conditions whose severity can range from mild irritabilities to life-threatening complications.

According to a recent report, corrective eye surgery was turned to as a resort for a certain type of Ehlers-Danlos Syndrome (EDS) in the past, and this recourse can be taken into account in times of need. However, it is only in very rare cases that eye surgery is recommended as a remedy for people suffering from EDS. This is because, if gone wrong, the surgery can invite high risks of scarring and other impediments that would worsen the malady further. For the uninitiated, EDS is caused by mutations that leave an impact on distinct types of collagen which, in turn, is the primary molecule that facilitates self-healing of a wound.

As opposed to common belief, a report published only recently, stated that one patient underwent the laser-assisted in situ keratomileuses (LASIK) surgery even before she was diagnosed with EDS. Back in 2001, the doctors delineated that corrective eye-surgery was the only way through which the 21-year-old Caucasian woman could be freed from myopia, or what is commonly known as nearsightedness. Although her medical history revealed that she suffered from intermittent arthralgias and hypermobile joints, it denied all the signs that are related to diabetes, abnormal scar formation, and tissue disease. The patient who was going through the treatment was adopted and hence, the physician couldn't get their hands on her family history that could have been otherwise useful for cross-reference. Amongst the medications that were prescribed, one of them was to resist allergies and the other one was for subsequent depression and anxiety.

Impact of the LASIK surgery.

Two years later, the same patient complained about experiencing increased itchiness and dryness in her eyes. When the doctors examined, they found out that there were two Salzmann nodules in each of the right and left eye. For those of you who might not know, Salzmann nodules hint at the gradual degeneration of the eye’s surface.

To alleviate the troubles, the doctors took to treating the patient’s eyes with cyclosporine ophthalmic emulsions along with preservative-free artificial tears. Even after their best efforts, the doctors failed to make the situation better and the patient continued to live with her eye inflammation. After three years, the patient’s primary care physician asserted that she had vascular EDS after encountering multiple miscarriages while she was subjected to numerous fertility treatments. More often than not, vascular EDS is associated with defective type III collagen but, in some cases, type I collagen can also be exposed to the weaknesses. The type I collagen and type III collagen specifically work for and affect the eyes. Type I collagen covers about 75% of the vertebrate eye and on the other hand, type III collagen, though present in extremely small amounts, increase during inflammation and wounding.
Nevertheless, the Salzmann nodules of the patient didn’t alter much but, interestingly, the doctors noticed that her vision was deteriorating by the day and there were also signs of Meibomian gland dysfunction; a condition that degrades dry eye by changing the composition of the thin tear film that safeguards the conjunctiva and cornea. Naturally, the treatments suggested comprised of artificial tears, olopatadine drops, and cyclosporine. Again, after two years (after seven years of the eye surgery) the patient needed punctual cautery in the lower eyelid of her right eye. The punctal cautery is a procedure in which the tear ducts of the eyes are sealed permanently so that tears do not drain out too quickly and the eyes are moist. Nonetheless, the doctors decided to conduct this operation finally after failing continuously at punctual plugs which too, does the same for the eye, but only temporarily.

Complications in the long run.

Following this, over the next 10 years' time, the patient was subjected to a uterine tear and abdominal hernias and thus, had to opt for consecutive reparative surgeries. Then the doctor discovered that the woman had two disorders that were linked with EDS, namely, mast cell activation syndrome and postural orthostatic tachycardia syndrome. The patient still gave birth to a son after a long wait but, unfortunately, child two was detected with EDS symptoms of degenerative myopia and hypermobile joints. All this while, the patient continued to experience the same abnormalities as those she did in the past. Poor night sight and exceedingly dry eyes led her to get punctual cautery in her left eye as well.

After 11 years of the patient's LASIK surgery, the doctors noticed neovascularization (which concerns the formation of new blood vessels across the deoxygenated regions) on her right's eye cornea that extended into the Salzmann nodules. The development did not occur overnight; the new blood vessels grew over a period of six years through which, the patient's vision kept declining. Moreover, she continued to go through the aggravations of dry eye symptoms but, did not require any surgical intervention.

The bottom line.

The bottom line of the research avers that the patient who underwent LASIK surgery came across a string of postoperative complications including dry eye syndrome, Salzmann modular degeneration, and myopic regression which were gravely disturbed by the latent disorder of collagen production.

As of now, LASIK surgery is not the first thing that doctors and surgeons would rely on to cure EDS owing to the patient's vulnerability to scarring on the eye. But, there is a school of thought that believes because EDS disrupts only a few types of collagens, in particular, the LASIK surgery might prove helpful to amend the disorder in some cases. All things said, the fact that this area still calls for a lot of research regarding the risks and benefits of the surgery, cannot be overlooked.