PURPOSE: To evaluate the clinical characteristics of newly diagnosed glaucomatous subjects who had a history of refractive corneal ablation surgery (RCAS). METHODS: Sixty-eight glaucomatous subjects who had a history of RCAS and 68 age- and visual field (VF) mean deviation-matched glaucomatous subjects with no history of RCAS were included. Intraocular pressure (IOP), central corneal thickness (CCT), VF, and retinal nerve fiber layer thickness determined by optical coherence tomography were assessed. Parameters were compared between patients with and without a history of RCAS. Between-eye comparisons in the same participant (more advanced vs. less-advanced eye, in terms of glaucoma severity) were performed in the RCAS group. RESULTS: With similar levels of glaucoma severity, those with a history of RCAS showed significantly lower baseline IOP and a thinner CCT than the eyes of individuals without a RCAS history (13.6 vs. 18.7 mmHg, 490.5 vs. 551.7 micrometer, all p < 0.001). However, the extent of IOP reduction after anti-glaucoma medication did not significantly differ between the two groups (17% vs. 24.3%, p = 0.144). In the between-eye comparisons of individual participants in the RCAS group, the more advanced eyes were more myopic than the less-advanced eyes (-1.84 vs. -0.58 diopter, p = 0.003). CONCLUSIONS: Eyes with a history of RCAS showed a similar level of IOP reduction as eyes without such a history after anti-glaucoma medication. Our finding that the more advanced eyes were more myopic than the less-advanced eyes in the same participant may suggest an association between glaucoma severity and myopic regression.
Adult ; Female ; Glaucoma/*complications/drug therapy/pathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Myopia/*complications/pathology/*surgery ; *Refractive Surgical Procedures ; Retrospective Studies ; Severity of Illness Index ; Tomography, Optical Coherence

PURPOSE: To evaluate the clinical characteristics of newly diagnosed glaucomatous subjects who had a history of refractive corneal ablation surgery (RCAS). METHODS: Sixty-eight glaucomatous subjects who had a history of RCAS and 68 age- and visual field (VF) mean deviation-matched glaucomatous subjects with no history of RCAS were included. Intraocular pressure (IOP), central corneal thickness (CCT), VF, and retinal nerve fiber layer thickness determined by optical coherence tomography were assessed. Parameters were compared between patients with and without a history of RCAS. Between-eye comparisons in the same participant (more advanced vs. less-advanced eye, in terms of glaucoma severity) were performed in the RCAS group. RESULTS: With similar levels of glaucoma severity, those with a history of RCAS showed significantly lower baseline IOP and a thinner CCT than the eyes of individuals without a RCAS history (13.6 vs. 18.7 mmHg, 490.5 vs. 551.7 micrometer, all p < 0.001). However, the extent of IOP reduction after anti-glaucoma medication did not significantly differ between the two groups (17% vs. 24.3%, p = 0.144). In the between-eye comparisons of individual participants in the RCAS group, the more advanced eyes were more myopic than the less-advanced eyes (-1.84 vs. -0.58 diopter, p = 0.003). CONCLUSIONS: Eyes with a history of RCAS showed a similar level of IOP reduction as eyes without such a history after anti-glaucoma medication. Our finding that the more advanced eyes were more myopic than the less-advanced eyes in the same participant may suggest an association between glaucoma severity and myopic regression.
Adult ; Female ; Glaucoma/*complications/drug therapy/pathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Myopia/*complications/pathology/*surgery ; *Refractive Surgical Procedures ; Retrospective Studies ; Severity of Illness Index ; Tomography, Optical Coherence

A 38-year-old woman developed diffusely distributed opacities with crystalline materials in the laser in situ keratomileusis (LASIK) interface of her eye after she was scratched by a sprig during mountain climbing. No sign of flap displacement was noted. Despite two days of topical and systemic antibiotics therapy, the corneal infiltration with interface opacities persisted. The following day, the distribution of the crystalline materials had rotated in a counterclockwise direction. Flap lifting and foreign body removal using sufficient irrigation were performed. One month after surgery, the patient's postoperative uncorrected visual acuity was 0.8 with cleared interface. No signs of epithelial ingrowth or flap striae were noted. Mild traumatic corneal scratching without flap displacement may threaten the integrity of the LASIK interface. If foreign bodies are suspected to be the cause of inflammation, early flap lifting with irrigation is imperative for successful treatment.
Adult ; Cornea/*injuries/pathology/surgery ; Eye Injuries/*complications/diagnosis/surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/surgery ; *Surgical Flaps ; Surgical Wound Dehiscence/diagnosis/*etiology/surgery ; Wounds, Nonpenetrating/*complications/diagnosis/surgery