Refractive surgery techniques could raise IOP and lead to glaucoma

Article

The risk of glaucoma after refractive surgery procedures should not be underestimated, claims José Belda, MD, speaking at the Alicante Refractiva International meeting, held March 6–8 in Spain.

The risk of glaucoma after refractive surgery procedures should not be underestimated, claims José Belda, MD, speaking at the Alicante Refractiva International meeting, held March 6–8 in Spain.

Dr Belda, of Vissum Institute in Alicante, said that, as the volume of refractive surgery is constantly increasing, and that the largest part of refractive surgery procedures are performed in myopic patients, amongst whom the prevalence of glaucoma is three- to four-times higher than normal, there may be a large quantity of patients presenting this problem in the future.

True intraocular pressure (IOP) levels are difficult to assess after surgery, regardless of the technique used: this can lead to IOP being underestimated, which results in glaucoma going undiagnosed for a long time. Each technique, however, can have additional problems of its own. For example, the high levels of corticosteroids used with surface techniques may lead to corticosteroid-induced glaucoma, particularly in patients with high myopia, while the pressure values during the vacuum phase of LASIK procedures can reach as high as 200 mmHg. Furthermore, the extra length of a femtosecond procedure can cause damage to the optic nerve because of the longer time that the cornea is flattened. It has not yet been proved whether this pressure increase is safe in eyes with underlying glaucoma or ocular hypertension.

Dr Belda concluded by saying that he believed that most cases of glaucoma after refractive surgery are related to corticosteroid-induced increases in IOP.

Newsletter

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

Recent Videos
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.
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
© 2025 MJH Life Sciences

All rights reserved.