Laser refractive surgery in glaucoma patients.

Glaucoma may not be an absolute contraindication to Laser-Assisted in situ Keratomileusis (LASIK), but so far it is a relative one. People who are glaucoma suspects or who have glaucoma are just as likely as any other to seek laser refractive surgery. LASIK is a popular ocular procedure, relatively pain free and it is carried out with an extremely precise computer-controlled excimer laser emission. On the other hand, glaucoma is a group of diseases manifested by optic nerve damage with visual field changes. Patients that undergo a transient but significant rise in intraocular pressure during LASIK procedure have risk of further optic nerve damage. Furthermore, steroids which are typically used after refractive surgery can increase intraocular pressure (IOP) especially in steroid responders, who are more prevalent among glaucoma patient. Glaucoma patients interested in LASIK surgery may visit a glaucoma specialist or another LASIK surgeon who has had experience with performing LASIK in glaucoma patients. PRK (photorefractive keratectomy), LASEK (laser epithelial keratomileusis) are good alternatives for glaucoma patients. Refractive surgeons might want to consider giving patients a photo of their optic nerve, or a drawing, or an objective record of their preoperative examination.