Refractive surgery in glaucoma

The purpose of this review is to discuss the topics relevant to the topic of LASIK in glaucoma patients or suspects. The safety of LASIK and the implications of LASIK on glaucoma diagnostic testing are reviewed.

Most studies have found no change in the nerve fiber layer thickness or optic disc after LASIK. Several reports of steroid-induced glaucoma after LASIK have been published. Important new syndromes such as the interlamellar stromal cyst have been described. Most investigators, but not all, have found intraocular pressure to be lower after LASIK, most likely an artifact of measurement as a result of reduced central corneal thickness.

The safety of LASIK in patients with glaucoma has not been proved. However, based on the published literature, LASIK may be a viable option for some glaucoma patients. Although not an absolute contraindication, glaucoma is a relative contraindication, and careful patient education and life-long follow-up is mandatory. The clinician must be ever mindful of the important effects that LASIK may have on diagnostic testing.