Clinical Ophthalmology (Aug 2018)
Risk factors for early onset elevated intraocular pressure after pterygium surgery
Abstract
Kevin Wu, Hyunjoo J Lee, Manishi A Desai Department of Ophthalmology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA Purpose: In this study, we aimed to identify the risk factors for early postoperative elevation of intraocular pressure (IOP) after pterygium surgery.Patients and methods: All patients in this retrospective cohort study were evaluated for inclusion from a single tertiary care center at Boston Medical Center. Their pre- and postoperative IOP measurements (day 1, week 1, month 1, month 3, and when clinically necessary) were compared. Patients with postoperative IOP measurement of >22 mmHg or with an increase in IOP by ≥10 mmHg compared with the preoperative measurement value were grouped as “Ocular Hypertension” group; otherwise, patients were grouped in the “No Ocular Hypertension” group. Age, sex, race, baseline IOP, cup-to-disc (C/D) ratio, history of glaucoma, and frequency of use of postoperative steroid drops in all patients were compared. Chi square test was performed to compare the categorical variables, whereas Student’s t-test was performed to compare continuous variables. We performed a multivariate logistic regression analysis of categorical data with a significance level of p < 0.05.Results: In total, 240 patient charts were reviewed for inclusion in this study. Twenty-six patients required pterygium surgery on both eyes; for these patients, the eye with higher IOP was analyzed. Two patients were discontinued from this study because of elevated IOP in the contralateral, nonsurgical eye. Forty-eight out of 212 eyes (22.64%) developed postsurgical elevation of IOP within the first 3 months of operation. No significant differences were found between age, sex, baseline IOP, C/D ratio, history of glaucoma diagnoses, and frequency of use of postoperative steroid drops. However, Hispanic/Latino race (p = 0.036) and lack of application of steroid ointment (p = 0.001) were found to be the significant risk factors for the development of “Ocular Hypertension” in multivariate analysis.Conclusion: Early elevation of IOP is a risk of pterygium surgery. One nonmodifiable risk factor, Hispanic/Latino race, and one modifiable risk factor, lack of application of steroid ointments, were identified as potential causes of early postoperative IOP elevation. Keywords: race, ocular hypertension, postoperative care, steroid, intraocular pressure
