Steroid Induced Ocular Hypertension Following Myopic Photorefractive Keratectomy

Abstract

<!--[if gte mso 9]><xml> Normal 0 false false false MicrosoftInternetExplorer4 </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p>PURPOSE: To determine the incidence of steroid induced ocular hypertension following myopic photorefractive keratectomy (PRK). METHODS: Myopic PRK was performed on 506 eyes of 269 patients. Preoperatively, spherical equivalent refractive error ranged from -1.00 to -5.00 diopters (D) and cylinder was less than 4 D. Baseline intraocular pressure (IOP) before PRK and at different time intervals after the procedure was measured by Goldmann applanation tonometry. IOP readings were corrected according to central corneal thickness as measured by Orbscan pachymetry. For the purpose of the study, corrected IOP > 21 mmHg was considered as ocular hypertension. RESULTS: Ocular hypertension developed in 40 (7.9%) eyes overall, which occurred in 16 eyes (40%) 2-3 weeks postoperatively (mean IOP=23.5±3.0mmHg), in 20 eyes (50%) after 4-6 weeks (mean IOP=25.1±4.2 mmHg) and in 4 eyes (10%) 8-12 weeks following PRK (mean IOP=29.0±3.1 mmHg). There was no correlation between the level of IOP rise and preoperative spherical equivalent refractive error. IOP recovered to normal in all eyes after discontinuation of topical steroids and initiation of anti-glaucoma medications. Mean duration of IOP normalization was 28.5±27.7 (range 7-108) days and no instance of steroid-induced glaucoma was observed in any patient. CONCLUSION: Topical steroids may cause ocular hypertension following PRK. Early detection, prompt treatment and close follow-up are recommended. We suggest measuring IOP in post-PRK patients no later than 10 to 14 days after initiation of corticosteroid treatment.</p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Font Definitions */ @font-face {font-family:Palatino; mso-font-alt:"Book Antiqua"; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:7 0 0 0 147 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; text-align:right; mso-pagination:widow-orphan; direction:rtl; unicode-bidi:embed; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]-->