Effects of an educational seminar on rejection demographics in patients presenting for laser in situ keratomileusis

Purpose. To evaluate the effectiveness of an educational seminar as an initial screening tool for patients interested in laser in situ keratomileusis (LASIK) and to determine the incidence of and reasons for patients not being candidates for the procedure. Methods. A retrospective review of the medical charts of 438 consecutive patients, half of whom attended an educational seminar, and half of whom did not. All patients underwent ophthalmic evaluations as candidates for LASIK. The reasons for patients not proving to be good candidates were determined. Results. Thirteen percent of all patients examined were found not to be suitable candidates for LASIK. There was no difference in rejection rates between patients who had attended a seminar and those who had been screened and educated over the telephone by a skilled technician. The principal reasons for rejection were, in decreasing order of frequency: cataract, presbyopia, abnormal corneal curvature, insufficient corneal thickness, unstable refraction, large pupil, irregular astigmatism, anterior basement membrane dystrophy, previous corneal surgery, uncontrollable dry eye, and previously undiagnosed ocular malignancy. Conclusions. Patients educated through group seminars or individually by trained technicians over the telephone still present for consideration for LASIK with unidentified ocular problems that make them poor surgical candidates. This occurs at a rate of 13%. The majority of the patients required a careful evaluation to uncover the abnormalities.