A correction formula for the real intraocular pressure after LASIK for the correction of myopic astigmatism.
OBJECTIVE
To create a correction formula to determine the real intraocular pressure (IOP) after LASIK considering the altered corneal thickness, corneal curvature, and corneal stability.


METHODS
This prospective clinical trial comprised 101 eyes of 59 patients (34 women and 25 men) that underwent LASIK with a mean preoperative spherical equivalent refraction of -6.3 +/- 2.17 diopters (D) (-3.0 to -11.5 D). Mean patient age was 32 +/- 9 years. Preoperatively and 6 months postoperatively, IOP (by Goldmann applanation tonometry), keratometry (by topography), and central corneal thickness (CCT) (by ultrasound pachymetry) were evaluated. These parameters were measured in all patients between 8 and 11 o'clock in the morning.


RESULTS
Due to the LASIK procedure, IOP was reduced from 16.5 +/- 2.1 mmHg (range: 12 to 22 mmHg) to 12.9 +/- 1.9 mmHg (range: 8 to 16 mmHg). Multiple linear regression analysis of the IOP values before and after LASIK showed a significant correlation between the measured IOP and CCT and keratometry values (R2=0.631; P<.001). After LASIK, the biomechanical bending strength of the cornea is reduced by the cut so that the measured IOP must be additionally corrected by 0.75 mmHg. An equation containing all three changes is given: IOP (real) = IOP (measured) + (540-CCT)/71 + (43-K-value)/2.7 + 0.75 mmHg.


CONCLUSIONS
Intraocular pressure measurements after LASIK for the correction of myopia are inaccurate as a consequence of changes in CCT, corneal curvature, and corneal flap stability. After LASIK, the measured IOP should be corrected to avoid false low IOP applanation readings.
Kohlhaas
Markus
M
Department of Ophthalmology, University of Dresden, Germany. markus.kohlhaas@uniklinikum-dresden.de
Spoerl
Eberhard
E
Boehm
Andreas G
AG
Pollack
Katharina
K
D000328:Adult; D000465:Algorithms; D001251:Astigmatism / Q000601:surgery*; D001696:Biomechanical Phenomena; D003315:Cornea / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D014065:Tonometry, Ocular / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography