Pregnancy is not without consequence on myopia which it tends to aggravate. However, it is not advisable to have surgery during these 9 months. For what reasons ? the answers of Pr Audrey Giocanti-Auregan and Pr Jean-Pierre Rozenbaum, ophthalmologists.
During pregnancy, the hormonal change can have consequences, such as dysfunction of the lacrimal glands and therefore a dry eye.
Certain vision problems such as myopia can worsen during pregnancy
It tends to worsen temporarily. “There exists a myopization about 1 diopter on average during pregnancy followed by a complete regression after delivery. This myopisation would be linked to increased water retention during pregnancy at the level of the cornea which modifies its thickness, its curvature and thus its refractive index. (light deflection power) Progestin and estrogen also increase the water permeability of the lens, which temporarily changes its refractive index.. On the other hand, the SUN cohort, an observational study involving more than 10,000 women, showed an absence of increased risk of initiating or worsening myopia in patients who had had at least one pregnancy compared to young women n not having had a pregnancy“, explains Pr Audrey Giocanti-Auregan, Head of the Ophthalmology Department at Avicenne Hospital, APHP, Sorbonne Paris Nord University.
Why are refractive surgeries prohibited during pregnancy?
It is not the intervention that is truly contraindicated, but rather its result that is compromised.
There refractive surgerywhich aims to correct vision problems, is not strictly speaking prohibited during these 9 months but it is not recommended during the 2nd and 3rd trimesters of pregnancy and specialists invite future mothers to postpone the interventions. “Hormonal changes during pregnancy, and in particular the secretion of progesterone whose rate increases significantly from the 5th week, explain this postponement. Corneal refractive surgery performed with a femtosecond and excimer laser will correct vision defects by acting on the curvature of the cornea. The surgeon establishes the power of the defect to be treated preoperatively and programs the laser according to this value. However, progesterone can cause water retention in the cornea which will modify its curvature and therefore its power. This change in curvature can lead temporarily to a temporary increase in myopia orastigmatism which usually regress after childbirth. Hormonal changes can also lead to variable phenomena of transient ocular dryness, resulting in gritty sensations or ocular irritation. These phenomena are temporary and occur rather after the 5th week and usually regress after childbirth. The (rare) risk is therefore to overestimate the default and to have more complicated consequences due to dry eyes in particular, from the 5th week“, underlines Professor Rozenbaum, ophthalmologist, specialist in refractive surgery and member of the National Academy of Surgery.
Can you have myopia surgery while breastfeeding?
It is also not recommended for a hormonal reason. ” At the end of pregnancy, there is a fall in progesterone and estrogen levels followed by an increase in prolactin. During breastfeeding, prolactin causes a decrease in estrogen secretion. This decrease in estrogen can promote dry skin and eyes through blood perfusion“, explains Professor Jean-Pierre Rozenbaum.
Does breastfeeding affect eyesight?
Also for the hormonal reasons mentioned above, the eyes are drier during postpartum which may cause stinging, itching, burning or gritty sensations in the eyes. Dry eyes are also manifested by sensitivity to light, watery eyes when it is windy or cold, sometimes blurred vision and visual fatigue at the end of the day.
Should I stop breastfeeding early to have surgery?
The intervention can wait but if it is really necessary, it is advisable to stop breastfeeding. “During breastfeeding, the main risk is postoperative dry eye.“, explains Professor Rozenbaum.