Intraocular pressure after excimer laser myopic refractive surgery

Abstract

The aim of this study was to determine whether intraocular pressure (IOP), as measured by Goldmann applanation or non-contact tonometry, shows systematic changes in patients who have undergone photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). IOP was measured by central Goldmann and non-contact tonometry in 54 patients pre and post-PRK, and in 43 patients pre- and post-LASIK. An interval of 12 months was allowed after surgery. Patients were selected to have one of four specific initial values of refractive error (−2.5, −5.0, −7.5 and −10.0D). Fellow unoperated eyes were used as controls. A paired Student's t-test and a one-way ANOVA test were used for statistical analysis. After PRK and LASIK, a statistically significant decrease (p<0.01) was observed in the IOP of the treated eyes (but not for control eyes; p>0.01). Although the magnitude of the change increased with the attempted refractive correction, this trend was not statistically significant (p>0.01). No statistically significant differences were found between the results obtained following the two types of surgery, although the recorded fall in IOP was smaller following LASIK (p>0.01). The IOP measured after PRK and LASIK for myopia may be reduced because of reduced corneal thickness and curvature and, possibly, tissue softening after natural healing. The presence or absence of Bowman's membrane does not appear to be important in this context. The reduction in measured IOP following refractive surgery, by about 0.5mmHg/D of myopic correction, needs to be remembered when possible abnormality of IOP in such patients is being considered.