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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...

Trabeculectomy with mitomycin C in refractory glaucoma associated with nonnecrotizing anterior scleritis.

Related Articles

Trabeculectomy with mitomycin C in refractory glaucoma associated with nonnecrotizing anterior scleritis.

Ocul Immunol Inflamm. 2009 Nov-Dec;17(6):420-2

Authors: Williams TA, Sii F, Chaing M, Murray PI, Shah P

Surgically induced necrotising scleritis (SINS) following sequential laser-assisted in situ keratomileusis (LASIK) and pterygium excision with conjunctival autograft. PURPOSE: To report a case of SINS occurring 1 month after uncomplicated pterygium excision with conjunctival autograft. SETTING: Department of Ophthalmology, Singleton Hospital, Abertawe Bro Morgannwg University NHS trust, United Kingdom. METHOD: A 70-year-old male presented with a 10 day history of redness and reduced vision in the right eye. Bilateral hyperopic LASIK and right eye pterygium excision with conjunctival autograft had been performed elsewhere, 6 months and 1 month prior to presentation. BCVA were 6/60 OD and 6/6 OS. A 2mm full thickness nasal corneal perforation with adjacent scleral melt (6.5 x 4mm) was evident. Tectonic full thickness corneal and scleral patch grafting with amniotic membrane graft overlay was performed with systemic immunosuppression (prednisolone 60 mg od). RESULTS: Recurrence of the cornea scleral melt occurred one month postoperatively on reduction of prednisolone to 15 mg od. This was initially managed successfully with cyclophosphamide 100mg and prednisolone 80 mg. Two months postoperatively recurrent corneal perforation required the application of cyanoacrylate glue. At latest follow up four months postoperatively the corneal glue is in situ with no evidence of recurrent melt. CONCLUSIONS: SINS following pterygium excision with conjunctival autograft is rare with only 2 case reports in the literature. This is the first reported case of SINS occurring after pterygium excision with conjunctival autograft with preceding LASIK.

PMID: 20001263 [PubMed - in process]

 

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Last updated Thursday, February 25, 2010

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