Does Bariatric Surgery Affect Intraocular Pressure?



The effect of body mass index (BMI) reduction following bariatric surgery on intraocular pressure (IOP) is not well established. We evaluated association between BMI reduction and IOP measurements and other ocular and metabolic parameters 1 year after bariatric surgery.

Materials and Methods

A retrospective study with over 1-year follow-up on patients who underwent weight reduction bariatric surgery between January 2016 and December 2016 at Wolfson Medical Center, Israel. Patient data was extracted from outpatient’s bariatric and ocular clinic records. Metabolic, ocular, and clinical parameters were assessed including BMI changes, IOP, central corneal and retinal nerve fiber layer thickness, optical coherence tomography, and biometry results.


Of 22 bariatric surgery patients, 15 underwent laparoscopic sleeve gastrectomy (LSG) and 7 laparoscopic mini gastric bypass (MGB). All were followed up for over 1 year after surgery. Average BMI decreased from 41.9 ± 7.3 to 25.5 ± 5.7 kg/m2 at 1-year follow-up (p < 0.001). Mean IOP decreased significantly by 21% after 1 year (p < 0.001). Decrease in IOP 1 year after surgery was correlated with decrease in IOP at 3-month follow-up (r = 0.677, p = 0.001), preoperative IOP (r = 0.837, p < 0.001), and corneal thickness (r = 0.589, p = 0.006), with no correlation between reduction in IOP and baseline weight, BMI, or the reduction in either (p > 0.05). Central corneal thickness and retinal nerve fiber layer thickness were also significantly decreased (p = 0.038) and (p = 0.018), respectively.


BMI reduction achieved by bariatric surgery was associated with significant and continued decline in IOP beyond 1 year after surgery. Clinical implications highlight the importance of considering bariatric surgery in patients with ocular hypertension.

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  1. 1.

    Cheung N, Wong TY. Obesity and eye diseases. Surv Ophthalmol. 2007;52:180–95.

    Article  Google Scholar 

  2. 2.

    Lam CTY, Trope GE, Buys YM. Effect of head position and weight loss on intraocular pressure in obese subjects. J Glaucoma. 2017;26:107–12.

    Article  Google Scholar 

  3. 3.

    Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357:753–61.

    Article  CAS  Google Scholar 

  4. 4.

    Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  Google Scholar 

  5. 5.

    Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.

    Article  Google Scholar 

  6. 6.

    Klein BE, Klein R, Linton KL. Intraocular pressure in an American community. The Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 1992;33:2224–8.

    PubMed  CAS  Google Scholar 

  7. 7.

    Hoehn R, Mirshahi A, Hoffmann EM, et al. Distribution of intraocular pressure and its association with ocular features and cardiovascular risk factors: the Gutenberg Health Study. Ophthalmology. 2013;120:961–8.

    Article  Google Scholar 

  8. 8.

    Ramdas WD, Wolfs RCW, Hofman A, et al. Lifestyle and risk of developing open-angle glaucoma: the Rotterdam study. Arch Ophthalmol. 2011;129:767–72.

    Article  Google Scholar 

  9. 9.

    Geloneck MM, Crowell EL, Wilson EB, et al. Correlation between intraocular pressure and body mass index in the seated and supine positions. J Glaucoma. 2015;24:130–4.

    Article  Google Scholar 

  10. 10.

    Boyd CH, Slagle WF, Boyd CM, et al. The effect of head position on electromyographic evaluations of representative mandibular positioning muscle groups. Cranio. 1987;5(1):50–4.

    Article  CAS  Google Scholar 

  11. 11.

    Lee LA. Perioperative visual loss and anesthetic management. Curr Opin Anesthesiol. 2013;26(3):375–81.

    Article  Google Scholar 

  12. 12.

    Rubino F. Bariatric surgery: effects on glucose homeostasis. Curr Opin Clin Nutr Metab Care. 2006;9:497–507.

    Article  CAS  Google Scholar 

  13. 13.

    Patterson EJ, Urbach DR, Swanström LL. A comparison of diet and exercise therapy versus laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity: a decision analysis model. J Am Coll Surg. 2003;196:379–84.

    Article  Google Scholar 

  14. 14.

    Mummadi RR, Kasturi KS, Chennareddygari S, et al. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2008;6:1396–402.

    Article  Google Scholar 

  15. 15.

    Groutz A, Gordon D, Schachter P, et al. Effects of bariatric surgery on male lower urinary tract symptoms and sexual function. Neurourol Urodyn. 2016;36:636–9.

    Article  Google Scholar 

  16. 16.

    Hua Y, Qiu W, Xiao Q, et al. Precision (repeatability and reproducibility) of ocular parameters obtained by the Tomey OA-2000 biometer compared to the IOLMaster in healthy eyes. PLoS One. 2018;13:e0193023.

    Article  CAS  Google Scholar 

  17. 17.

    Burgansky-Eliash Z, Achiron A, Hecht I, et al. Reduction of intraocular pressure after bariatric surgery. Acta Ophthalmol. 2018;96:e592–5.

    Article  Google Scholar 

  18. 18.

    Viljanen A, Hannukainen JC, Soinio M, et al. The effect of bariatric surgery on intraocular pressure. Acta Ophthalmol. 2018;96:849–52.

    Article  Google Scholar 

  19. 19.

    IIhan E, Celalettin V, Kucukkartallar T, et al. The increase of intra-abdominal pressure can affect intraocular pressure. Biomed Res Int. 2015:1–4.

  20. 20.

    Stojanov O, Stokić E, Šveljo O. The influence of retrobulbar adipose tissue volume upon intraocular pressure in obesity. Vojnosanit Pregl. 2013;70:469–76.

    Article  Google Scholar 

  21. 21.

    Çekiç B, Doğan B, Toslak IE, et al. The effect of bariatric surgery on the retrobulbar flow hemodynamic parameters in patients with obesity: color Doppler evaluation. Int Ophthalmol. 2017;38:1–6.

    Google Scholar 

  22. 22.

    Celebi ARC, Mirza GE. Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2013;54:8095–103.

    Article  Google Scholar 

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The authors express their gratitude to Ms. Dalia Dawn Orkin for her English language contributions and editing services.

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Correspondence to Mordechai Shimonov.

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The authors declare that they have no conflict of interest.

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The study was performed following all the guidelines for experimental investigations required by the Institutional Review Board of the Edith Wolfson Medical Center.

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Shimonov, M., Hecht, I., Yehezkeli, V. et al. Does Bariatric Surgery Affect Intraocular Pressure?. OBES SURG 30, 3742–3746 (2020).

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  • Body mass index
  • BMI
  • Bariatric surgery
  • Intraocular pressure
  • IOP
  • Glaucoma