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First Author: H.Lin TAIWAN
Co Author(s): P. Hsu Y. Chou C. Pu Y. Fang
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This study is to evaluate the blood pressure (BP) changes for patients underwent LASIK surgery with flap created with the femtosecond laser under topical anesthesia (i-LASIK), and to determine the factors associated with BP changes for these patients.
All operations were performed by the same surgeon (Dr HY Lin) in one clinic (Universal eye center).
There were 209 patients received i-Lasik surgery between Jan, 2012 and Oct, 2012. All operations were performed by the same surgeon using the same 120K Hz IntraLase femtosecond laser (Abbott Medical Optics, Inc.) and EC-5000 excimer laser (Nidec). The pre-operative systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured 3 times using the same barometer when patient visited the clinic on the day of operation. The post-operative BPs were measured after patients surgery has completed for at least 5 minutes. Patients was categorized by their pre-operative SBP as normal-tensive (BP<120 mmHg), pre-hypertensive (120<=BP<140mmHg) and hypertensive subjects (BP>=140 mmHg).
There were 110 female and 90 male subjects. Their mean age was 30.2 + 6.4 (19.8~49.1) years old. There were 126 patients (63%) with normal tensive status, 57 (28.5%) with pre-hypertensive status, and 17(8.5%) with hypertensive status in pre-operative period. There was 64.7% of pre-op hypertensive patients remain in hypertensive status, and 5.9% return to normal after i-Lasik surgery. Their SBP changes were +5.9, -0.6 and -8.6 mmHg respectively; and their DBP changes were +7.0, +5.2 and -3.4mmHg respectively. The SBP change was significantly associated with pre-operative SBP status (p<0.0001) and IOP (p=0.008), but not with patients age (p=0.562), gender (p=0.243), their refractive status (p=0.786) and CCT (p=0.599).
This study revealed that 12% of patient without hypertension developed hypertensive status (JNC 7 classification) pre-operatively and increased to 20% post-operatively. The SBP changes were significantly associated with their SBP status before operation. For patient safety, hemodynamic monitoring should be implemented into routine LASIK surgery.