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Abstract #45960 Published in IGR 13-2
Refractive surgery and the glaucoma patient
Shrivastava A; Madu A; Schultz JCurrent Opinions in Ophthalmology 2011; 22: 215-221
PURPOSE OF REVIEW: Patients considering corneal refractive surgery undergo extensive preoperative testing, but current protocols may not address the management of glaucoma appropriately. This review outlines the current body of literature on the diagnostic and management challenges that exist in the treatment of glaucoma patients undergoing laser ablative surgery, and makes recommendations to improve current perioperative protocols. RECENT FINDINGS: As permanent structural alterations to the cornea after laser-assisted in-situ keratomileusis surgery make Goldmann applanation tonometry inaccurate, the advent of new diagnostic modalities and recommendations to accurately measure postoperative intraocular pressure (IOP) and subtle damage to the optic nerve have been further analyzed and tested. SUMMARY: As IOP is the only modifiable risk factor in the treatment of glaucoma to date, traditional diagnostic and treatment algorithms may not be appropriate for refractive surgery patients. Glaucoma remains a relative contraindication to refractive procedures, but as new diagnostic modalities emerge, our ability to diagnose and manage these patients may improve. More uniform recommendations need to be implemented to improve our long-term management of these patients.
A. Shrivastava.
Classification:
8.4 Refractive surgical procedures (Part of: 8 Refractive errors in relation to glaucoma)
