LASIK and Glaucoma: Is it Safe?

As the second most common cause of blindness in the United States, glaucoma is a serious eye condition. Affecting an estimated 4 million people in the U.S., only half actually know they have it. Glaucoma is a group of diseases which, over time, damages the optic nerve due to the characteristic increase in intraocular pressure (IOP). It is the increase of the pressure within the eyes that creates the need for further assessment in those seeking clear vision through LASIK.

During the LASIK procedure, there is a brief increase in IOP during the flap creation process. While this is not a concern for those with normal eye pressures, this can be cause for concern in glaucoma patients.

During a LASIK pre-operative examination, a comprehensive look at the eyes is performed to verify overall health and stability. A look into the patients’ eye history is also important to verify that the glaucoma is properly controlled. Finally, the surgeon will look at the patients’ optic nerve to see if there is any nerve damage due to the glaucoma. If there is a lot of nerve damage, most LASIK surgeons will recommend not having LASIK. If the nerve looks good and the glaucoma is stable, the patient should be cleared to have the procedure.

An alternative for those who have glaucoma and a healthy optic nerve is to have PRK (photorefractive keratectomy). Since no flap is created in the PRK procedure, the risk of increasing IOP during the procedure is alleviated.

Following LASIK or PRK, it is important that the patient receive careful monitoring of their IOP, optic disc, nerve fiber layer and visual fields to ensure that the procedure does not affect the glaucoma.

“The pressure in the eye changes following refractive surgery, which it is why such careful monitoring is necessary,” said James Kiley, MD, Refractive Surgeon at Raleigh Eye Center.

For those considering LASIK who have glaucoma, the visual benefits outweigh the risks. This is especially the case in younger patients. These patients often do not want to wear glasses and the use of contact lenses puts them at an increased risk for an eye infection. Having LASIK or PRK removes the possibility of contact lens related infections from the realm of possibilities.

At Raleigh Eye Center, we strive to ensure that each person who is interested in having LASIK is thoroughly evaluated to minimize the risk of adverse events. If you or someone you know is interested in having LASIK and has glaucoma, contact our office today for a consultation to determine if the procedure is possible. For more information, contact our Refractive Surgery Department at (919) 876-2427.