라식 수술 후 압평안압계와 비접촉성 안압계 측정치간 큰 차이를 보인 1예

• 영문명: A Wide Discrepancy between Intraocular Pressure by Applanation and Non-contact Tonometry after LASIK
• 발행기관: 대한안과학회
• 저자명: 김진철 정태영 기창원,Jin Chul Kim, M.D., Tae Young Chung, M.D., Chang Won Kee, M.D.
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume48,number6, 873~877쪽, 전체 5쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2007.06.30

영문 초록

Purpose: To report the case of a glaucoma patient with a history of LASIK surgery who presented with a wide discrepancy in intraocular pressure between the Goldmann applanation tonometry and non-contact tonometry. Methods: A 20-year-old male glaucoma patient was referred to our clinic with a chief complaint of blurred vision in his right eye. The patient had a history of uneventful bilateral LASIK surgery. Upon our initial examination, his best-corrected visual acuity in the right eye was 0.04 and his right eye IOP was 14 mmHg by Goldmann applanation tonometry and 40 mmHg by non-contact tonometry. A slit lamp examination showed corneal epithelial edema with diffuse interface opacities. The central corneal thickness in the right eye was 587 ?m. An ultrabiomicroscopy demonstrated an interface fluid accumulation between the LASIK flap and the stromal bed. The patient was diagnosed with juvenile open-angle glaucoma and was scheduled for a trabeculectomy. Results: Seven days after trabeculectomy, the patient`s vision in the right eye improved to 0.7 and his IOP was 12 mmHg by Goldmann applanation tonometry and 14 mmHg by non-contact tonometry. In addition, the corneal epithelial edema, interface opacities, and fluids had all resolved and the central corneal thickness was reduced to 489 ?m. Conclusions: In eyes that have undergone LASIK surgery, the IOP measured by Goldmann applanation tonometry may underestimate the true pressure due to fluid accumulation under the LASIK flap. In such cases, non-contact tonometry can be a convenient and a reliable method for determining treatment plan.

키워드

Goldmann applanation tonometry, Interface fluid, LASIK, Non-contact tonometry