1. Željka Jojić, Specijalna bolnica za oftalmologiju Profesional dr Suvajac, Zemun, Srbija, Albania
INTRODUCTION: Glaucoma patients present a unique set of challenges to physicians performing corneal refractive surgery.
THE AIM: was to determine whether performing PRK in glaucoma suspects leads to damage progression in CVF and HRT in 6 months follow up.
MATERIAL AND METHODS:In our study were analyzed 356 consecutive myopic eyes undergoing laser correction of vision using LASIK or PRK. Total myopic spherical equivalent was -4.75 ± 2.25Dsph. Of these, in 39 eyes (11%) photorefractive keratectomy (PRK) was done. Total of 31 patients (61 eyes) were sent to the examination for suspected glaucoma. Reasons for examination were borderline or elevated intraocular pressure (12 patients-24 eyes), suspected clinical appearance of the optic nerve disc (14 patients-27 eyes) or a positive family history of glaucoma (2 patients eye-4-1.1% of myopic eyes). 1 patient was excluded from further tests and refractive surgery the exam confirmed the existence of damage and defects in the visual field. Of the 30 patients referred for further examination in 15 (30 eyes) were advised that the intervention is performed using PRK. In the rest of the suspects glaucomatous changes were excluded so they underwent LASIK. All patients were monitored postoperatively in terms of high IOP and repeated findings of HRT and CVF.
RESULTS: In patients undergoing LASIK method, which are sent to the preoperative additional tests has not been observed shift in the IOP-in, even with the correction factor due to changes in corneal thickness during the six-month follow-up, or changes in the findings of KVP and HRT.
In 10 patients after PRK is not observed high in IOP for 6 months. In three patients during the first 10 postoperative days was measured IOP reached values 20 ± 2 In two patients 7 days after laser IOP was 26 and 27 mmHg. They were treated with timolol corticosteroid therapy treatment was reduced. Pressure measured after 6 days was in the range of normal values. During further follow-up, there was no change in IOP values. In following postoperative CVF and HRT signs of progression or damage were not observed.
CONCLUSION: In the literature there is data that implies that previous glaucoma suspects can progress to further damage in the visual field and HRT after LASIK and are advised to undergo PRK. Our patients with even the slightest doubt on the existence of glaucoma damage, underwent PRK and in the first 6 months progression to the CVF and HRT was not observed.
Ključne reči :
Tematska oblast:
retraktivna hirurgija
Uvodni rad:
Da
Datum:
02.04.2012.
Br. otvaranja:
959
