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KMID : 1159320130150030373
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Korean Journal of Vision Science
2013 Volume.15 No. 3 p.373 ~ p.285
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Analysis of Factors Affecting Intraocular Pressure after Corneal Refractive Surgery
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Kim Hyun
Lee Koon-Ja
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Abstract
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Purpose: To investigate the significant parameters that affect intraocular pressure (IOP) measured by non-contact tonometry in patients who have undergone corneal refractive surgery. Methods: One hundred fifty four subjects (261 eyes) who underwent Laser in Situ Keratomileusis (LASIK) or Laser assisted sub-epithelial keratomileusis (LASEK) were participated. IOPs were measured with non-contact tonometer (KT-800, KOWA, JAPAN) and corneal curvature, corneal ablation amount and central corneal thickness measurement were performed by using Orbscan topography (Orbscan II, Busch + Lomb, USA). The correlation between the changes of IOP and the changes of central corneal thickness, corneal curvature drop and corrected diopter value were investigated statistically using SPSS 18.0 (SPSS Inc, Chicago, Illinois). Differences were considered significant when the P vale was less than 0.05. Results: The subjects who received corneal refractive surgery were in the mean age of years and 83 patients (131 eyes) were in LASIK group and 71 patients (130 eyes) were in LASEK group. The Pre and post operative IOPs showed positive correlation with the central corneal thickness (R=0.25, p<0.05 and R=0.133, p<0.05). The post-operative IOPs were decreased over the periods of operation and there was no difference between the types of refractive surgery (p=0.192). The postoperative IOP changes showed positive correlation with the amounts of corneal ablation (R=0.348, p<0.05) and corrected dipoters (R=0.334, p<0.05) and changes of the corneal curvature (R=0.355, p<0.05). The underestimated IOPs per ablation, 1 diopter correction and 1 diopter corneal curvature change were 0.031mmHg, 0.41mmHg and 0.637mmHg respectively. Conclusions: The IOPs measured with non-contact tonometer after refractive surgery were decreased, and the amount of underestimated IOP was increased with corneal ablation amount. For the patients who have undergone LASIK or LASEK, we recommend that their falsely postoperative low IOP readings would result in delay in diagnosis of glaucoma.
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KEYWORD
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Corneal refractive surgery, Intraocular pressure, Central corneal thickness, Corneal ablation amount, Corrected dipoter, LASIK, LASEK
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