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Refractive Surgery and Glaucoma
Dick H. B., Pfeiffer N.,
Johannes-Gutenberg-Universität Mainz, Universitäts-Augenklinik (Mainz)
Corneal refractive procedures (e.g., LASIK, PRK, corneal rings, laser thermokeratoplasty and a growing list of other procedures) fundamentally alter corneal contour and thickness. The size of the optical zone, pupil size, centration, and extent of refractive correction are some of the variables of refractive laser correction. Glaucoma (e.g., steroid-induced, angle-closure, pigmentary glaucoma) fortunately is an uncommon postoperative complication. Until now the greatest concern has been the effect of the acute IOP rise while creating the corneal flap during the LASIK procedure. Unfortunately, the most pressing issue regarding glaucoma has received only modest attention. The normative parameters of conventional glaucoma screening tools, including tonometry, perimetry, and disc analysis, are being altered by most refractive procedures. Some of the assumptions for applanation tonometry (e.g., the applanating surface is dry, thin, flexible and a perfect sphere) often are no longer valid after refractive surgery.