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Glaucoma must be managed before Lasik laser eye surgery.

 

Glaucoma is a condition in which the internal ocular pressure (IOP) of the eye is elevated, causing damage to the optic nerve. The most common type of glaucoma will show no symptoms until loss of vision has started, but can be diagnosed with a complete eye examination. Glaucoma can be treated with medicated eye drops, laser surgery, and/or conventional surgery.

Glaucoma is detected by the measurement of the eye pressure, visual examination of the optic nerve during a complete eye exam, and a visual field test to determine if loss of vision has started.

Aqueous humor flows into and out of the anterior chamber of the eye to bathe and nourish the intraocular structures. When a patient has glaucoma, the fluid drains too slowly out of the anterior chamber. As the fluid builds up, the pressure inside the eye rises. If the eye pressure is not controlled, damage to the optic nerve may occur, which will lead to vision loss and eventually blindness if not treated.

Glaucoma may be a problem if you are considering refractive surgery, but different types of refractive surgery are less problematic than others. Individuals with very highly IOP or predisposed to glaucoma may not be appropriate for conventional or custom wavefront Lasik, All-Laser Lasik, or Epi-Lasik, but may be appropriate for other types of refractive surgery like PRK, LASEK, NearVision CK, P-IOL, or RLE. While glaucoma does not automatically exclude a person from many refractive surgery techniques, glaucoma should be treated and stabilized before considering refractive surgery.

During Lasik, All-Laser Lasik, and Epi-Lasik surgery, a microkeratome is affixed to the eye with suction. This suction greatly increases the IOP of the eye for a brief time. The temporarily elevated IOP may negatively affect a patient with glaucoma or someone predisposed to glaucoma. PRK, LASEK, CK, P-IOL, and RLE do not require a microkeratome and do not dramatically raise the patient's IOP. These techniques may (emphasis on "may") be appropriate for consideration.

About 3 million people in the United States have glaucoma. Some risk factors for glaucoma include a family history of glaucoma, ancestry of the Negro race, high blood pressure, diabetes, smoking, advanced age, the use of corticosteroids, and previous ocular trauma. If you have been previously diagnosed with glaucoma or are a member of a glaucoma risk group, be sure to discuss with your refractive surgeon any concerns you may have regarding refractive surgery and glaucoma. An FDA approved online glaucoma test is available that you can use from your own computer to determine if you have glaucoma. Visit Online Glaucoma Test

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.


Current Lasik and Glaucoma Medical Journal News...

Toric implantable collamer lens for patients with moderate to severe myopic astigmatism: 12-month follow-up.

Related Articles

Toric implantable collamer lens for patients with moderate to severe myopic astigmatism: 12-month follow-up.

Clin Experiment Ophthalmol. 2010 Mar 2;

Authors: Bhikoo R, Rayner S, Gray T

Abstract Purpose: To report on the 12-month follow-up of 77 eyes with moderate to high myopic astigmatism implanted with toric implantable collamer lenses (ICLs). Methods: Retrospective case-note review of 77 eyes from 42 patients undergoing toric ICL placement by one surgeon. Preoperative mean spherical equivalent -2.50 dioptres (D) to -15.00 D myopia and 1.00 D to 7.00 D astigmatism. Results: At 12 months, mean manifest refractive cylinder (MRC) decreased 81% from 2.38 D to 0.44 D. MRC within 1.00 D occurred in 99% (76/77) of eyes, whereas 86% (66/77) had MRC within 0.75 D. 99% (76/77) had postoperative best-corrected visual acuity (BCVA) better than or equal to preoperative values, whereas 78% (60/77) gained up to one line BCVA and 1% (1/77) lost one line BCVA. Uncorrected binocular vision of 6/6 or better occurred in 90% (38/42) of patients compared with binocular BCVA of 6/6 or better in 67% (28/42) preoperatively. One ICL was replaced due to low vaulting. Two eyes with astigmatism of 3.25 D and 3.50 D received subsequent laser in situ keratomileusis (LASIK) to reduce residual small refractive errors. Indications for ICL were: myopia too high for LASIK (73%), cornea too thin for LASIK (44%) and contact lens intolerance (33%). Night halos were reported in 10% (8/77) of eyes at 12 months. One ICL was removed due to unrecognized preoperative glaucoma. There were no cases of cataract formation, or endophthalmitis. Conclusion: This study is the largest reported series of toric ICL implantation in New Zealand. It supports the safety, efficacy and predictability of toric ICLs to treat myopic astigmatism.

PMID: 20584028 [PubMed - as supplied by publisher]

 

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Last updated Monday, April 12, 2010

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