Laser refractive surgery in glaucoma patients

ABSTRACT

Glaucoma may not be an absolute contraindication to Laser-Assisted in situ Keratomileusis [LASIK], but so far it is a relative one. People who are glaucoma suspects or who have glaucoma are just as likely as any other to seek laser refractive surgery. LASIK is a popular ocular procedure, relatively pain free and it is carried out with an extremely precise computer-controlled excimer laser emission. On the other hand, glaucoma is a group of diseases manifested by optic nerve damage with visual field changes. Patients that undergo a transient but significant rise in intraocular pressure during LASIK procedure have risk of further optic nerve damage. Furthermore, steroids which are typically used after refractive surgery can increase intraocular pressure [IOP] especially in steroid responders, who are more prevalent among glaucoma patient. Glaucoma patients interested in LASIK surgery may visit a glaucoma specialist or another LASIK surgeon who has had experience with performing LASIK in glaucoma patients. PRK [photorefractive keratectomy], LASEK [laser epithelial keratomileusis] are good alternatives for glaucoma patients. Refractive surgeons might want to consider giving patients a photo of their optic nerve, or a drawing, or an objective record of their preoperative examination