Is TransPRK more suitable for me than LASIK if I have glaucoma?

Any refractive surgery procedure thins the cornea in order to correct your refractive error. A thinner cornea makes the measurement of the eye pressure less reliable because a thinner cornea produces a falsely low eye pressure. This means that if your eye pressure was truly high (more than 21), because of a thinner than normal cornea, your eye pressure reading may measure 17 (which deceptively looks normal). Hence, this makes it less reliable as a glaucoma indicator.

Personally, I have seen bad cases of glaucoma who have come to me after years of being undetected and untreated, until there is irreversible visual damage, because the prior attending doctor did not monitor eye pressure closely and did not realise glaucoma was creeping in.

In your case, if you have glaucoma, it might be in your best interest to avoid such refractive procedures which make monitoring of your glaucoma more difficult. Unless you have a responsible eye doctor who can advise you and monitor your glaucoma closely through other means such as retinal nerve fiber layer thickness and visual field analysis.

Hope that helps!

Dr Claudine Pang

A main concern for glaucoma patients undergoing other laser vision correction procedures like LASIK or ReLEx SMILE is the use of the suction ring intra-operatively, which will cause a sustained increased eye pressure for a minute and this may cause irreversible damage to the already damaged optic nerve.

However with TransPRK, there is no suction ring device applied to your eyes. If your glaucoma is mild to moderate and is well-controlled with medications, you should be suitable for the TransPRK procedure even if you have glaucoma.

Of course, if you are considering the TransPRK procedure, you should first go down to the clinic for a detailed eye evaluation and a consultation with your eye surgeon. He would be the best person who after assessing your eyes’ condition decide if your eyes are suitable or not for the procedure.