Glaucoma progression in eyes with a history of refractive corneal surgery

Invest Ophthalmol Vis Sci. 2012 Jul 3;53(8):4485-9. doi: 10.1167/iovs.12-9862.

Abstract

Purpose: To evaluate the glaucoma progression in patients with a history of refractive corneal surgery (RCS).

Methods: A total of 313 eyes of 313 glaucoma patients (RCS group, 34 eyes; non-RCS group, 279 eyes) with a mean follow-up period of 2.7 years were included. Glaucoma progression was determined either by experts' stereoscopic optic disc/retinal nerve fiber layer (RNFL) photographs or by serial visual field (VF) data. Uni- and multivariate Cox's proportional hazards models were used to determine associations between potential risk factors including a history of RCS and glaucoma progression.

Results: Among 313 eyes, 87 (27.8%) eyes showed progression either by optic disc/RNFL photographs or VF assessment during the follow-up period. Ten (29.4%) of eyes in the RCS group and 77 (27.6%) of eyes in the non-RCS group showed glaucoma progression; however, prevalence of progression did not differ between the two groups (P = 0.482). Among all participants, baseline age and VF pattern standard deviation (PSD; hazard ratios of 1.013 and 1.119; P = 0.026 and P < 0.001, respectively) were significant risk factors for progression. In both the RCS and the non-RCS group, only VF PSD was a significant risk factor for progression according to multivariate Cox proportional hazards (1.193, 1.099, P < 0.001, P < 0.001, respectively).

Conclusions: Baseline VF PSD and age substantially affected glaucoma progression in all study participants, although their RCS history was not a significant risk factor for glaucoma progression.

MeSH terms

  • Adult
  • Corneal Surgery, Laser*
  • Disease Progression
  • Female
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Myopia / physiopathology
  • Myopia / surgery*
  • Nerve Fibers / pathology
  • Optic Disk / pathology
  • Proportional Hazards Models
  • Retinal Ganglion Cells / pathology
  • Risk Factors
  • Visual Acuity / physiology
  • Visual Fields / physiology