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IOP not the only parameter for diagnosing, treating glaucoma in refractive surgery patients

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BOSTON — Measuring parameters other than IOP is important to diagnosing and treating glaucoma in patients who have undergone refractive surgery, a physician said here.

Retinal nerve fiber layer, optic disc and visual field measurements are important to monitor in the refractive patient population, Thomas W. Samuelson, MD, said at the World Glaucoma Congress.

"Keratorefractive surgery alters IOP measurements. There are devices that now are available that are far less influenced by corneal biomechanics," Dr. Samuelson said.

Of the 1 million to 1.4 million eyes that undergo refractive surgery each year in the United States, an estimated 2% are predestined to develop glaucoma. He said that dispelling myths about the role of IOP is vital to correctly diagnose the disease in the refractive surgery population.

For patients who have undergone refractive surgery with pre-existing glaucoma, it is also key to increase surveillance of all measurement parameters, Dr. Samuelson said, because IOP can be underestimated after refractive surgery in glaucoma patients.