Change in intraocular pressure measurements after LASIK the effect of the refractive correction and the lamellar flap.

OBJECTIVE

To study the relationship between intraocular pressure (IOP) readings after LASIK and the amount of refractive correction.

DESIGN

Retrospective noninterventional case series.

PARTICIPANTS

Patients receiving primary LASIK for myopia and myopic astigmatism.

METHODS

A database of preoperative, intraoperative, and 3-month postoperative data for 8113 consecutive eyes that underwent primary myopic and myopic astigmatic LASIK was retrospectively reviewed. Linear regression analysis of measured IOP change as a function of refractive change was then performed. Age and preoperative keratometry were also reviewed by multiple regression.

MAIN OUTCOME MEASURES

Best-fit curve relating change in measured IOP to refractive change.

RESULTS

The mean spherical equivalent of the refractive change was -4.98+/-2.64 diopters (mean +/- standard deviation). The mean decrease in measured IOP was 2.0+/-3.3 mmHg. Linear regression analysis revealed a decrease of 0.12 mmHg of measured IOP per diopter of refractive change (95% confidence interval [CI], 0.09-0.15, R(2) = 0.009, P<0.001). Extrapolation of the data to a theoretical correction of zero diopters revealed a decrease of 1.36 mmHg (95% CI, 1.20-1.51, P<0.001), suggesting a component of measured IOP change that is independent of laser ablation.

CONCLUSIONS

The reduction of IOP readings after corneal refractive surgery is a linear function of the amount of refractive correction, with an additional constant reduction that is probably related to the lamellar corneal flap. These data suggest that the lamellar corneal flap makes no contribution to the load-bearing characteristics of the post-LASIK cornea.