The relationship between glaucoma and refractive surgery is often the source of a certain number of misunderstandings, including among certain ophthalmologists, particularly when they are neither believers nor practitioners of surgery for myopia, hypermetropia, astigmatism, or presbyopia.
Any repair surgery with discover vision center for example for vision abnormalities presupposes a certain number of prerequisites, and the notion of a progressive disease such as glaucoma does not place the patient who is a candidate for such surgery in the best possible position.
It is obvious that faced with a patient suffering from glaucoma that is advanced or unbalanced by his medical treatment; any refractive surgery is out of place.
This is not the case even when faced with a patient suffering from moderate glaucoma, perfectly balanced under medical treatment, and wishing to free himself from wearing glasses. The situation is again different in a patient without glaucoma but with a family history prompting careful monitoring to detect the signs of incipient glaucoma.
In these last two situations, the main thing is to consider that the eye pressure figures will be modified postoperatively, especially after myopia surgery by Lasik, due to the cornea’s thinning.
We know that there are biases in the measurement of ocular pressure linked to corneal thickness independently of the surgery. The measured voltage thus appears higher when the cornea is thicker and lower when it is thinner.
We can thus make an erroneous diagnosis of glaucoma in patients whose cornea is very thick, but above all, we can overlook true glaucoma in certain patients whose ocular pressure is normal but underestimated because of a thin cornea. This last hypothesis is more damaging because it can lead to extremely late diagnoses of glaucoma when the disease has destroyed a large part of the fibers of the optic nerve.
The relationship between glaucoma and myopia surgery is that corneal thinning linked to Lasik or PKR surgery will lead to an apparent drop in tension, proportional to the induced thinning, itself proportional to myopia operated on.
In situations of moderate glaucoma or a family risk situation for glaucoma, this modification must therefore be taken into account, and a new grid for reading the eye pressure figures must be adopted, taking into account corneal thinning.
It is also essential to explain to the patient this modification of the tension figures after Lasik so that he informs of this surgery and any other ophthalmologist who would be brought to take care of him later. In contrast, the traces of the myopia surgery may have disappeared since they can sometimes become indistinguishable over time. Learn about lasik surgery pros and cons here.
