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Glaucoma patients should be educated prior to refractive surgery

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SAN FRANCISCO — Education and a lifelong follow-up are strongly urged for patients with glaucoma who want to undergo refractive surgery, according to a poster presentation at the American Society of Cataract and Refractive Surgery meeting.

Seung Hyuck Lee, MD, and colleagues examined the clinical course of 10 eyes of 12 patients with glaucoma who had undergone refractive surgery, including LASIK for myopia, LASEK, and Artisan/Verisyse lens (Ophtec/Advanced Medical Optics) implantation.

Dr. Lee compared preoperative and postoperative IOP, refractive error, visual acuity and endothelial cell counts. He said both endothelial and keratocyte cell density remained the same. Mean cup-to-disc ratio was 0.7, he said. A mean IOP decrease of 4.7 mm Hg was observed, and there was no progression in visual field loss over the course of the 1-year follow-up.

Dr. Lee said glaucoma patients may be viable candidates for refractive surgery, but the physician should monitor the patient for the rest of his/her life, and should ensure a high level of patient education preoperatively as well.