IOP must be monitored in refractive surgery patients

Article

In eyes that have undergone corneal refractive surgery, non-Goldmann measurements of intraocular pressure (IOP) and continued examination of the optic nerve is essential as changes of the corneal shape can lead to falsely low IOP values.

In eyes that have undergone corneal refractive surgery, non-Goldmann measurements of intraocular pressure (IOP) and continued examination of the optic nerve is essential as changes of the corneal shape can lead to falsely low IOP values, according to a report published in the January issue of the Journal of Refractive Surgery.

Alexander Friedrich Scheuerle and colleagues from the University of Heidelberg, Germany, reported on a case of advanced glaucomatous optic atrophy years after bilateral radial keratotomy in a 40-year old woman.

Multiple IOP measurements of both eyes were obtained using Goldmann applanation tonometry as well as air-puff and Schiotz tonometry. In addition to regular eye examinations, corneal thickness, surface and shape were examined using Orbscan and C-scan.

The cornea of both eyes did not show signs of thinning but flattening of the corneal surface was observed. The decreased corneal curvatures precipitated a misjudgement of IOP readings measured by central applanantion tonometry (12 to 18 mmHg), whereas impression and non-contact tonometry revealed elevated IOP values (21 to 27 mmHg).

The authors believe that changes in corneal shape, without corneal thinning, can lead to falsely low IOP values and therefore, in eyes that have undergone corneal refractive surgery, non-Goldmann measurements and continued examinations of the optic nerve are recommended.

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Christine Curcio, PhD, of the University of Alabama at Birmingham Heersink School of Medicine, shares histology update and revised nomenclature for OCT with Sheryl Stevenson of the Eye Care Network and Ophthalmology Times
SriniVas R. Sadda, MD, FARVO, shares key points from his retina presentation at the International SPECTRALIS Symposium
Robert Sergott, MD, describes fluorescence lifetime imaging ophthalmoscopy (FLIO) and the International SPECTRALIS Symposium – And Beyond (ISS) in Heidelberg, Germany.
Rayaz Malik, MBChB, PhD, a professor of medicine at Weill Cornell Medicine - Qatar, spoke with Ophthalmology Times Europe about his presentation. It's titled "An eye on neurodegenerative diseases: Challenging the dogma" at the International SPECTRALIS Sympsoium. In conversation with Hattie Hayes, Ophthalmology Times Europe
Anat Loewenstein, MD, describes her presentation on remote imaging for age-related macular degeneration and geographic atrophy at the International SPECTRALIS Symposium, in conversation with Hattie Hayes of Ophthalmology Times Europe
Tyson Brunstetter, OD, PhD, a US Navy Aerospace Optometrist at the NASA Johnson Space Center in Houston, Texas, shares key takeaways from his keynote at the International SPECTRALIS Symposium (ISS)
Rayaz Malik, MBChB, PhD, shares his presentation, titled An eye on neurodegenerative diseases: Challenging the dogma, at this year's International SPECTRALIS Symposium
At the Retina World Congress, Siegfried Priglinger, MD, speaks about ensuring the best outcomes for preschool-aged patients
At the 2025 ASCRS meeting, Robert Ang, MD said small aperture IOLs can benefit all patients, especially those with complex corneas or who have undergone previous corneal refractive surgery
Viha Vig, MBChB graduate student at the University of Auckland, New Zealand, discusses her poster presentation on the relationship between mitochondiral disease, Alzheimer disease, and other types of dementia.
© 2025 MJH Life Sciences

All rights reserved.