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Abstract #12509 Published in IGR 7-2
Considerations of glaucoma in patients undergoing corneal refractive surgery
Bashford KP; Shafranov G; Tauber S; Shields MBSurvey of Ophthalmology 2005; 50: 245-251
Glaucoma patients present a unique set of challenges to physicians performing corneal refractive surgery. Corneal thickness, which is modified during corneal refractive surgery, plays an important role in monitoring glaucoma patients because of its effect on the measured intraocular pressure. Patients undergo a transient but significant rise in intraocular pressure during the laser-assisted in situ keratomileusis (LASIK) procedure with risk of further optic nerve damage or retinal vein occlusion. Glaucoma patients with filtering blebs are also at risk of damage to the bleb by the suction ring. Steroids, typically used after refractive surgery, can increase intraocular pressure in steroid responders, which is more prevalent among glaucoma patients. Flap interface fluid after LASIK, causing an artificially low pressure reading and masking an elevated pressure has been reported. The refractive surgeon's awareness of these potential complications and challenges will better prepare them for proper management of glaucoma patients who request corneal refractive surgery.
Dr. K.P. Bashford, Department of Ophthalmology and Visual Sciences, Yale University School of Medicine, New Haven, Connecticut; Glaucoma Consultants of Colorado, P.C., Littleton, Colorado, USA
Classification:
8.4 Refractive surgical procedures (Part of: 8 Refractive errors in relation to glaucoma)