Effects of antiglaucoma drugs on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis

Am J Ophthalmol. 2008 Feb;145(2):233-238. doi: 10.1016/j.ajo.2007.09.036. Epub 2007 Dec 11.

Abstract

Purpose: To assess effects of antiglaucoma drugs on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK).

Design: Prospective, nonrandomized clinical trial.

Methods: We examined 27 eyes with mean myopic regression +/- standard deviation of -1.26 +/- 0.48 diopters (D; range, -0.50 to -2.25 D) after LASIK. Nipradilol 2.5% was administered topically twice daily to these regressive eyes. We obtained the refraction (spherical equivalent, astigmatism), intraocular pressure (IOP) measurements, pachymetry, geometry, and refractive power of the cornea before and three months after treatment.

Results: Mean manifest refraction was improved significantly from -1.02 +/- 0.52 D to -0.44 +/- 0.39 D (P < .001). However, mean manifest astigmatism was changed from -0.55 +/- 0.30 D to -0.49 +/- 0.22 D, but the difference was not significant (P = .23). The IOP was decreased significantly from 11.4 +/- 2.4 mm Hg to 9.4 +/- 1.3 mm Hg (P < .001). Central corneal thickness was not changed significantly from 505.2 +/- 39.3 microm to 503.6 +/- 38.7 microm (P = .61). The posterior corneal surface was shifted posteriorly by 9.1 +/- 8.2 microm, and the total refractive power of the cornea was decreased significantly, by 0.63 +/- 0.62 D (P < .001), at three months after application.

Conclusions: The preliminary data show that antiglaucoma drugs are effective for the reduction of the refractive regression, especially of the spherical errors, after LASIK. It is suggested that backward movement of the cornea may occur, possibly flattening the corneal curvature by lowering the IOP. Reduction of the IOP may contribute to improving regression after keratorefractive surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Topical
  • Adrenergic beta-Antagonists / administration & dosage*
  • Adult
  • Astigmatism / physiopathology
  • Cornea / drug effects*
  • Cornea / physiopathology
  • Female
  • Humans
  • Intraocular Pressure / drug effects
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer
  • Male
  • Middle Aged
  • Myopia / drug therapy*
  • Myopia / physiopathology
  • Ophthalmic Solutions / administration & dosage
  • Postoperative Complications*
  • Propanolamines / administration & dosage*
  • Prospective Studies
  • Refraction, Ocular / drug effects
  • Visual Acuity

Substances

  • Adrenergic beta-Antagonists
  • Ophthalmic Solutions
  • Propanolamines
  • nipradilol