The Influence of Breastfeeding on PRK Outcomes: A Comparison of Visual and Refractive Results

Purpose To compare the visual and refractive outcomes of breastfeeding versus non-breastfeeding women who underwent photorefractive keratectomy (PRK) surgery. Methods In this retrospective study, medical files of women who underwent PRK surgery between January 2013 and December 2023 were reviewed. The patients were divided into two groups: women who reported breastfeeding during their screening examination and women who did not. Pre-, intra-, and post-operative parameters were compared between the groups. Results The study included 12,843 eyes from 6,567 women, with 550 eyes from breastfeeding women. Time from screening to surgery was similar between groups (159.5 ± 412.5 vs. 142.8 ± 390.6 days, P = 0.331). Breastfeeding women were older (28.7 ± 4.8 vs. 25.6 ± 6.7 years, P < 0.001), had shorter follow-up (61.0 ± 72.9 vs. 70.6 ± 84.0 days, P = 0.008), higher keratometry (44.78 ± 1.49 vs. 44.55 ± 1.54 D, P < 0.001), worse myopia (SEQ −5.31 ± 2.54 vs. −4.65 ± 2.45 D, P < 0.001), and worse uncorrected visual acuity (UCVA: 1.3 ± 1.1 vs. 1.22 ± 1.05, P = 0.006) and best corrected visual acuity (BCVA: 0.04 ± 1.0 vs. 0.03 ± 1.0, P = 0.02). Postoperative UCVA (0.03 ± 0.85 vs. 0.04 ± 0.8) and BCVA (0.03 ± 0.89 vs. 0.03 ± 0.85) were similar. Breastfeeding was not linked to higher retreatment rates (P = 0.79). Multivariate analysis found no significant differences. Conclusion Women who reported breastfeeding on average 5 months prior to surgery achieved visual and refractive outcomes comparable to non-breastfeeding women. PRK appears to deliver satisfactory results within the early postoperative period assessed in this study. Nevertheless, these exploratory findings do not establish long-term refractive stability and should not be interpreted as supporting a change in standard clinical counseling during lactation.