KMID : 0360220070480060860
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Journal of the Korean Ophthalmological Society 2007 Volume.48 No. 6 p.860 ~ p.865
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A Wide Discrepancy between Intraocular Pressure by Applanation and Non-contact Tonometry after LASIK
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Kim Jin-Chul
Kee Chang-won Chung Tae-Young
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Abstract
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Purpose:To report the case of a glaucoma patient with a history of LASIK surgery who presented with a wide discrepancy in intraocular pressure between the Goldmann applanation tonometry and non-contact tonometry.
Methods:A 20-year-old male glaucoma patient was referred to our clinic with a chief complaint of blurred vision in his right eye. The patient had a history of uneventful bilateral LASIK surgery. Upon our initial examination, his best-corrected visual acuity in the right eye was 0.04 and his right eye IOP was 14 mmHg by Goldmann applanation tonometry and 40 mmHg by non-contact tonometry. A slit lamp examination showed corneal epithelial edema with diffuse interface opacities. The central corneal thickness in the right eye was 587 ¥ìm. An ultrabiomicroscopy demonstrated an interface fluid accumulation between the LASIK flap and the stromal bed. The patient was diagnosed with juvenile open-angle glaucoma and was scheduled for a trabeculectomy.
Results: Seven days after trabeculectomy, the patient`s vision in the right eye improved to 0.7 and his IOP was 12 mmHg by Goldmann applanation tonometry and 14 mmHg by non-contact tonometry. In addition, the corneal epithelial edema, interface opacities, and fluids had all resolved and the central corneal thickness was reduced to 489 ¥ìm.
Conclusions: In eyes that have undergone LASIK surgery, the IOP measured by Goldmann applanation tonometry may underestimate the true pressure due to fluid accumulation under the LASIK flap. In such cases, non-contact tonometry can be a convenient and a reliable method for determining treatment plan
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KEYWORD
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Goldmann applanation tonometry, Interface fluid, LASIK, Non-contact tonometry
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