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Objective: To report the incidence of optic nerve damage in patients with ocular hypertension (OHT) 4 years after LASIK treatment and to study the relationship of transient IOP rises during LASIK treatment to optic nerve damage and to determine potential risk factors for glaucoma progression in OHT patients after LASIK treatment.
Design: cohort retrospective study
Methods: A cohort retrospective study review of 139 patients with OHT who underwent LASIK surgery at BMA hospital was performed from 2008 – 2012. All patients were followed up for optic nerve damage for 4 years. Glaucoma progression was determined by using CTVF and OCT. Cox proportional hazard model was used to determine potential risk factors such as age, IOP, CCT and VCD ratio.
Results: Among 139 patients, 6 eyes of 6 patients (4.3%) developed POAG (95%CI: 09% to 7.7%), the incidence rate of POAG at 4 years was 2.9%. No glaucoma progression was found at 1 year after LASIK treatment. Age and IOP were significant risk factors for the development of glaucoma, (HR= 1.12, 1.91; p = 0.038, 0.025) respectively.
Conclusion: The incidence of patients who developed POAG after LASIK at 4 years was low (4.3%) compared to the OHTS group at 5 years (9.5%, non-treatment group). LASIK does not increase the risk of OHT patients in developing glaucoma. Brief rises in IOP during Keratomileusis did not damage the optic nerve. Age and IOP play the important roles in glaucoma progression for OHT patients.
Conflicts of interest: None
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2. Bushley DM, Parmley VC, Paglen P. Visual field defect associated with laser in situ keratomileusis. Am J Ophthalmol 2000;129(50):668-71
3. Cameron BD, Saffra NA, Strominger MB. Laser in situ keratomileusis-induced optic neuropathy. Ophthalmology 2001;108(4):660-5
4. Lee AG, Kohnen T, Ebner R. Optic neuropathy associated with laser in situ keratomileusis. J Cataract Refract Surg 2000;26(11):1581-4.
5. Kim YJ, Yun SC, Na JH, Tchah HW, Jung JJ, Sung KR. Glaucoma Progression in eyes with history of Refractive Corneal Surgery. Investigative Ophthalmology & Visual Science 2012;53(8):4485-9
6. Xuan Z. Keratorefractive surgery and Glaucoma. Int J Ophthalmol 2008;1(3):189-94
7. Doughty MJ, Zanman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. SurvOphthanlmol. 2000;44:367-408.
8. Faucher A, Gregoria J, Blondeau P. Accuracy of Goldmann Tonometry after refractive surgery. J Cataract Refract Surg 1997;23:832-8.
9. Fournier AV, Podtenev M, Lemire J, Thompson P, Duchesne R, Perreault C, et al. Intraocular pressure change measure by Goldman tonometry after Laser in situ keratomileusis. J cataract Refract Surg 1988;24:905-10.
10. Denetyev DD, Kourenkov VV, Rodin AS, Fadeykina TL, Diaz MTE. Retinal nerve fiber layer changes after LASIK evaluated with optical coherence tomography. J Refract Surg 2005;21(5):S623-7.
11. Brown SM, Bradley JC, Xu KT, Chadwick AA, McCartney DL. Visual field changes after laser in situ keratomileusis. J cararact Refract Surg. 2005;31(4):687-93.
12. Ozdamar A, Kucuksumer Y, Aras C, Akova N, Ustundag C. Visual field changes after laser in situ keratomileusis. J Cataract Refract Surg. 2004;30(5):1020-3.
13. Katz J,Sommer A, Gaasterland DE, Anderson DR. Comparison of analytic algorithms for detecting glaucomatous visual loss. Arch Ophthalmol 1991;109:1684-9
14. Leske MC, Heiji A, Hyman L, Bengtsson B. Early Manifest Glaucoma Trial: design and baseline data. Ophthalmology 1999;106:2144-53.
15. Sommer A, Miller NR, Pollack I, Maumenee AE, George T. The nerve fiber layer in the diagnosis of glaucoma. Arch Ophthalmol 1977;95:2149-56.
16. Sommer A, Katz J, Quiley HA, Miller NR, Robin AL, Richter RC, et al. Clinical detectable nerve fiber atrophy precedes the onset of glaucoma field loss. Arch Ophthalmol 1991;109:77-83.
17. Chan KC, Poostchi A, Wong T, Insull EA, Sachdev N, Wells AP. Visual field changes after transient elevation of intraocular pressure in eyes with and without glaucoma Ophthalmology 2008;115(4):667-72..
18. Wensor MD, McCarty CA, Stanislavsky YL, Livingston PM, Taylor HR. The prevalence of glaucoma in the Melbourne Visual Impairment Project. Ophthalmology 1998;105:733-9.
19. Vizzeri G, Bowd C, Wienreb RN, Balasubramanian M, Medeiros FA, Sample P, et al. Determinants of agreement between confocal scanning laser tomography and standardize assessment of glaucomatous progression. Ophthalmology 2010;117:1953-9.
20. Leung CK, Liu S, Wienreb RN, Lai G, Ye C, Cheung CY. Evaluation of retinal nerve fiber layer progression in glaucoma a prospective analysis with neuroretinal rim and visual field progression. Ophthalmology 2011;118:1551-7.