Transient Diagnostics and Therapeutic-Related Increase in Intraocular Pressure and Risk to the Glaucoma Patient

This review evaluates the impact of transient intraocular pressure (IOP) elevations during common ophthalmic surgical and diagnostic procedures on glaucoma patients. Elevated IOP is a key risk factor in glaucoma, and while transient IOP spikes are frequently encountered during surgeries like cataract extraction, laser in situ keratomileusis (LASIK), and femtosecond laser-assisted cataract surgery (FLACS), the clinical significance of these short-term elevations remains uncertain, particularly for eyes with compromised optic nerves. There is still a lack of data on which IOP level and duration of IOP insult the glaucoma damage occurs. Still, it is known that the combination of the degree of IOP elevation, duration of the insult and optic nerve susceptibility are important determinants of this event. While transient IOP elevations during these procedures are generally well tolerated, patients with advanced glaucoma and severely compromised optic nerves may be at greater risk for further damage. More research is needed to fully understand the long-term implications of acute IOP spikes, particularly in patients with advanced disease.