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Abstract #15972 Published in IGR 2-3
Refractive surgery and the glaucoma patient. Customized corneas under pressure (editorial)
Lewis RAOphthalmology 2000; 107: 1621-2
This guest editorial discusses the relationship between the effect of surgery, cornea, pressure and glaucoma. The first point discussed is the possibility that glaucoma may result from a refractive procedure. This chance is in fact very low. Steroid induced pressure rises have been reported and aphakic IOL's may cause pupillary block. The real problem however is the change of intraocular pressure measurement after refractive surgery. For every three diopters increase in corneal curvature there is an estimated 1 mmHg increase in IOP. Thin cornea's underestimate IOP and thick cornea's overestimate IOP. Again the conversion factor for differences in corneal thickness is not entirely clear. Intra-ocular pressure after LASIK is reported to decrease by some 2-4 mmHg. In fact, most studies used applanation tonometry however the assumptions supporting this type of tonometry are no longer valid. A new type of tonometry is necessary for determining the true IOP. Glaucoma is not a disease of simple pressure. This author feels that the results of refractive surgery may also influence perimetry and optic disc analysis. For this statement he does not provide evidence. At the end of his editorial he offers five points of advice for those who consider refractive surgery. The last point of advice has to do with the fact that Tiger Woods claims to be a better golfer after LASIK surgery. This may not apply to everyone of us.
Classification:
6.1 Intraocular pressure measurement; factors affecting IOP (Part of: 6 Clinical examination methods)
8.4 Refractive surgical procedures (Part of: 8 Refractive errors in relation to glaucoma)