Diagnosis of steroid-induced glaucoma after photorefractive keratectomy

Takefumi Yamaguchi, Dogru Murat, Itaru Kimura, Kazuno Negishi, Kenya Yuki, Kazuo Tsubota, Yuichiro Ohtake

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Abstract

PURPOSE: To report steroid-induced glaucoma after photorefractive keratectomy (PRK). METHODS: A 50-year-old Japanese woman was referred for end-stage glaucoma 9 months after PRK. Topical fluorometholone 0.1% was administered for corneal subepithelial haze in both eyes for 9 months after PRK. Pneumatic non-contact tonometry values of intraocular pressure (IOP) remained normal (range: 11 to 17 mmHg), until she was diagnosed with end-stage steroid-induced glaucoma with extensive restriction in visual fields. At the patient's initial examination in our hospital, IOP measured by Goldmann applanation tonometry was 34 mmHg in the right eye and 32 mmHg in the left eye, but the estimated IOP as corrected by central corneal thickness measurement was >40 mmHg in both eyes. RESULTS: The patient underwent uneventful bilateral trabeculectomies, resulting in reduction of IOP to <10 mmHg in both eyes. CONCLUSIONS: The underestimation of IOP after PRK led to advanced visual field loss. Careful evaluation of IOP, optic disc, and visual field tests are indispensable to avoid such a devastating outcome after PRK.

Original languageEnglish
Pages (from-to)413-415
Number of pages3
JournalJournal of Refractive Surgery
Volume24
Issue number4
Publication statusPublished - 2008 Apr 1

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ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

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