LASIK surgery is a popular eye procedure that is used to correct vision problems such as myopia, hyperopia, and astigmatism. It is a relatively painless procedure that is performed with a computer-controlled excimer laser. While LASIK can improve vision, it cannot improve the condition of glaucoma. Glaucoma affects the optic nerve of the eye, while LASIK improves the cornea of the outer layer of the eye. However, LASIK may still be an option for some patients with glaucoma, especially if the pressure inside the eye is considered to be under control.
The surgeon can choose between PRK and LASIK, but both are similar forms of laser vision correction. PRK usually causes a minor increase in pressure during surgery, so it is sometimes the preferred method of laser vision correction. After LASIK or PRK surgery, patients with glaucoma should know that future IOP measurements must be adjusted to determine a true reading. While this isn't difficult, it's simply an additional consideration to ensure that glaucoma treatment remains effective. If a patient is refused LASIK surgery because they have glaucoma, it may be advisable to visit a glaucoma specialist or other LASIK surgeon who has experience performing LASIK surgery in patients with glaucoma. Physicians should also be aware of the risk factors for glaucoma who undergo LASIK surgery, such as myopia, hyperopia, a family history of glaucoma, high intraocular pressure, diabetes, and suspicious onset of the optic nerve.
To be clear, LASIK is not a treatment for either type of glaucoma. However, laser eye surgery may still be an option for some patients with primary open-angle glaucoma. Patients who experience a transient but significant increase in intraocular pressure during the LASIK procedure are at risk of additional damage to the optic nerve. Acute closed-angle glaucoma may occur after LASIK, especially in farsighted patients, and should be prevented through meticulous examinations, including gonioscopy. There is a fear that, as the LASIK population ages, glaucoma will go unnoticed in large numbers of people. Pre-existing glaucoma should not be an absolute contraindication for LASIK surgery, but a relative contraindication since each patient must be evaluated individually and further studies are still needed to determine if the procedure presents any additional risks. The most important detail of the LASIK evaluation is that refractive surgery is not contraindicated in patients at risk or with glaucoma, but the individual's glaucoma must be treated and stabilized before any intervention.
It was reported that a case of unilateral angle-closing glaucoma after hypermepic correction with LASIK was successfully managed by laser iridotomy (Paciuc et al.).As LASIK gains more popularity and acceptance, many patients diagnosed with glaucoma want to undergo LASIK. However, it's important to remember that there is no direct cause and effect relationship between the two conditions. Certain subgroups of patients who undergo LASIK may be at risk of suffering from glaucoma. It's common for potential patients with glaucoma to ask if they qualify for LASIK surgery. LASIK for myopia makes the cornea thinner and current reference standards for measuring eye pressure are not very accurate in post-LASIK eyes.
Glaucoma may not be an absolute contraindication for laser-assisted in-situ keratomileusis (LASIK), but so far it's relative.
