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Tonometric Changes of Latanoprost-Induced Intraocular Pressure Reduction after Photorefractive Keratectomy

From the Institute of Ophthalmology, Catholic University, Rome, Italy.

PURPOSE. To assess whether tonometric measurements of the drop in intraocular pressure (IOP) induced by 0.005% latanoprost are modified after photorefractive keratectomy (PRK).

METHODS. Data from 24 randomly selected eyes of 24 patients (12 men and 12 women, mean age ± SD: 31.7 ± 6.2 years) who were undergoing bilateral PRK for myopia (-6.38 ± 2.26 D) were obtained. Objective refraction, central corneal thickness (CCT), anterior radius of corneal curvature (R), and IOP measurements at baseline and 24 hours after 1 drop of 0.005% latanoprost, were performed before and 6 months after PRK. All measured IOPs were recalculated by a correction factor for CCT and R and expressed as true IOP (IOPT) measurements.

RESULTS. The mean CCT ± SD was 544.58 ± 36.03 and 463.21 ± 38.59 µm, and the anterior radius of corneal curvature was 7.73 ± 0.26 and 8.33 ± 0.37 mm, before and after PRK, respectively. The mean IOP at baseline was 15.8 ± 2.92 and 12.23 ± 2.37 mm Hg, and after latanoprost administration was 12.54 ± 1.97 and 10.19 ± 1.47 mm Hg, before and after PRK, respectively. The mean IOPT at baseline was 15.46 ± 1.08 and 16.18 ± 2.31 mm Hg, and after latanoprost administration was 11.85 ± 1.56 and 12.96 ± 1.71 mm Hg, before and after PRK, respectively. The mean IOP and IOPT reductions after latanoprost administration were, respectively, 3.25 ± 1.66 and 3.61 ± 1.7 mm Hg before PRK, and 2.03 ± 1.42 and 3.22 ± 1.79 mm Hg after PRK. Pre- and postoperative IOP reduction significantly differed (P < 0.001), but not IOPT.

CONCLUSIONS. The effect of hypotensive drugs on IOP readings may be underestimated because of measurement errors due to CCT reduction and R increase after PRK for myopia. Misdiagnosis of reduced pharmacologic efficacy may be avoided if the measured IOP is corrected by a proper nomogram.

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