Glaucoma is not a contraindication for refractive surgery performed to remove glasses. However, is there any association between these surgeries and glaucoma progression?
A retrospective observational cohort study by Sujin and Rim, included 65 eyes of 65 patients with primary open angle glaucoma (POAG) who underwent refractive corneal surgery (RCS).
Glaucoma progression was determined based on structural changes in optic disc/retinal nerve fiber layer (RNFL) photographs and/or visual field (VF) deterioration.
Cox proportional hazards analysis was used to identify risk factors for disease progression.
VF mean deviation (MD) and RNFL thickness progression rates obtained using a linear mixed-effects model were compared across tertile groups based on axial length (AXL) and central corneal thickness (CCT), respectively.
Over the follow-up period (mean: 9.1±2.9 y), 23 eyes (35%) exhibited glaucomatous progression.
The progression group had significantly longer AXL (P<0.001), thinner CCT (P=0.009) compared with those in the stable group.
Multivariate analysis identified longer AXL [hazard ratio (HR): 1.507, P=0.037] and thinner CCT (HR: 0.988, P=0.037) as significant predictors of glaucoma progression.
VF MD declined faster in the middle and highest AXL tertile groups, whereas RNFL thinning was the most pronounced in the highest AXL tertile group.
The lowest CCT tertile group exhibited the fastest VF MD decline and RNFL thinning.
Conclusion:
Patients with POAG and a history of RCS who present with longer axial length and thinner central corneal thickness, are at significantly higher risk of glaucomatous progression, highlighting the importance of vigilant long-term monitoring in these eyes.
REFERENCE:
Yeo S, Sung KR. Factors Associated With Glaucomatous Progression in Eyes With Prior Refractive Corneal Surgery. J Glaucoma. 2026 Mar 1;35(3):157-165. doi: 10.1097/IJG.0000000000002682. Epub 2025 Dec 17. PMID: 41474867.
No comments:
Post a Comment