Photorefractive surgery with excimer laser and its impact on the diagnosis and follow-up of glaucoma. A review

Arango, Alexandra; Tello, Alejandro; Parra, Juan Camilo; Galvis, Virgilio

doi:10.31348/2021/08

Cited by 3 publications

(2 citation statements)

References 49 publications

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“…A recent review on the impact of photorefractive surgery with excimer laser on the diagnosis and follow-up of glaucoma from Arango et al [30 ▪ ] provides recommendations to mitigate these challenges. The authors suggest calculating a personalized IOP correction factor by comparing the difference in mean IOP between a series of preoperative and stable postoperative IOP measurements.…”

Section: Postoperative Considerationsmentioning

confidence: 99%

Refractive surgery for the glaucoma suspect

Hein

Tauber

Shrivastava

2023

Current Opinion in Ophthalmology

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Purpose of reviewThe aim of this study was to provide an update on perioperative considerations in the evaluation and management of patients undergoing primary corneal and intraocular refractive procedures who are at risk for progressive glaucomatous optic neuropathy.Recent findingsThe necessity of a comprehensive baseline assessment prior to refractive procedures with structural and functional testing, along with documentation of preoperative intraocular pressure (IOP) measurements, is highlighted in recent literature. Substantiation of the increased risk of postoperative IOP elevation in keratorefractive procedures in patients with higher baseline IOP and lower baseline CCT, but not necessarily the degree of myopia, has been variably evidenced. Tonometry methods which are less influenced by postoperative corneal structural change should be considered in patients undergoing keratorefractive procedures. Vigilence in postoperative monitoring for progressive optic neuropathy is suggested given evidence of an increased risk of steroid-response glaucoma in these patients. Additional evidence for the IOP-lowering impact of cataract surgery in patients with an increased risk of glaucoma is provided, irrespective of intraocular lens choice.SummaryPerforming refractive procedures on patients at risk for glaucoma remains controversial. Definitive steps to optimize patient selection along with vigilance in disease state monitoring with longitudinal structural and functional testing can help mitigate potential adverse events.

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Section: Postoperative Considerationsmentioning

confidence: 99%

Refractive surgery for the glaucoma suspect

Hein

Tauber

Shrivastava

2023

Current Opinion in Ophthalmology

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“…Therefore, IOP measurement before refractive surgery is a part of patient selection. Even after surgery, IOP needs to be monitored, and if high, prompt intervention is needed [ 13 ]. The findings on the reliability of a tonometer to measure IOP in myopic patients undergoing refractive surgeries are inconclusive, as are recommendations for its use over GAT [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Intraocular Pressure Measured by Transpalpebral Method Using Diaton and Rebound Tonometry by iCare in the Eyes Before and After Transepithelial Photorefractive Keratectomy (TPRK) in Saudi Arabia

Alzuhairy¹

2022

Cureus

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Introduction: Intraocular pressure (IOP) measurement is vital to select and monitor a patient undergoing ocular surgery. The validity of tonometry by independent researchers is useful. In this paper, we compare intraocular pressure (IOP) by rebound tonometry using iCare (Tiolat Oy, Helsinki, Finland) with transpalpebral IOP (tpIOP) method by using Diaton (Bicom Inc., NY, USA) before and after transepithelial photorefractive keratectomy (TPRK) in Saudi Arabia.Methods: This cross-sectional validity study was held at a private ophthalmology hospital in central Saudi Arabia from January 2021 to February 2022. The tonometry was performed before, at week 1 (W1), and month 1 (M1) after TPRK. The tpIOP and IOP by iCare were compared using matched-pair analysis. The agreement in IOP by two methods was reviewed using the Bland-Altman plot. Central corneal thickness (CCT), spherical equivalent (SE) before surgery, and gender were correlated to the difference in IOP by two tonometers. The main outcome was the difference in IOP measured by Diaton and iCare.Results: We studied 202 eyes of 101 patients. The median difference in IOP by Diaton and iCare was -1.0 mmHg before, at W1, and M1 follow-ups. Before surgery, tpIOP by Diaton was 15.0±2.8 mmHg and by iCare was 16.0±3.7 mmHg (P<0.001). At W1, tpIOP was 15.9±2.5 mmHg and 16.9±3.4 mmHg by iCare (P<0.001). At M1, tpIOP was 15.7±4.1 mmHg and 16.5±5.4 mmHg by iCare (P<0.001). IOP by two methods was within ±2 mmHg in 73.3%, 69.8%, and 75.2% of the eyes before, at W1, and M1 of TPRK. Pre-CCT (P<0.001) was the significant predictor of the difference in IOP by two methods at W1 and M1 (P=0.001). iCare gave the overestimation of IOP compared to Diaton in 18.3%, 22.8%, and 17.8% of the eyes before, W1, and M1 follow-ups.Conclusions: IOP by iCare and Diaton was similar. Central corneal thickness was the predictor of IOP differences by tonometers.

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Intraocular Pressure Measurement after Penetrating Keratoplasty

Dumitrescu¹,

Istrate

Macovei

et al. 2022

Diagnostics

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Assessing the intraocular pressure is a difficult but crucial task in the follow-up of patients that have undergone penetrating keratoplasty. Early recognition of elevated intraocular pressure and/or glaucoma and establishment of the appropriate treatment is essential to ensure the best possible visual outcome for patients dealing with this feared complication. Although Goldmann applanation tonometry is still the gold standard for measuring the intraocular pressure, its limitations in postkeratoplasty eyes, due to postoperative modified corneal morphology, have led to the search for more suitable alternatives. This review is the result of a comprehensive literature search in the MEDLINE database that aims to present glaucoma in the context of perforating keratoplasty, the corneal properties with impact on ocular pressure measurement, and the results achieved with the most important tonometers that have been studied in this pathology. Goldmann applanation tonometry remains the reference for intraocular pressure assessment even in corneas after penetrating keratoplasty. However, some promising alternatives have emerged, the most important of which are the Pascal dynamic contour tonometry, the Tono-Pen XL, the ocular response analyzer, and the iCare. All have advantages and disadvantages but have proved to be appropriate alternatives, especially in cases in which Goldmann applanation tonometry cannot be used.

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Photorefractive surgery with excimer laser and its impact on the diagnosis and follow-up of glaucoma. A review

Cited by 3 publications

References 49 publications

Refractive surgery for the glaucoma suspect

Refractive surgery for the glaucoma suspect

The Comparison of Intraocular Pressure Measured by Transpalpebral Method Using Diaton and Rebound Tonometry by iCare in the Eyes Before and After Transepithelial Photorefractive Keratectomy (TPRK) in Saudi Arabia

Intraocular Pressure Measurement after Penetrating Keratoplasty

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