Risk factors predicting steroid-induced ocular hypertension after photorefractive keratectomy.

PURPOSE

To assess the risk factors contributing to steroid-induced ocular hypertension after photorefractive keratectomy (PRK).

SETTING

Care Laser Centers, Tel Aviv, Israel.

DESIGN

Retrospective case series.

METHODS

Patients having PRK between January 2000 and December 2015 were followed for at least 3 months. Intraocular pressure (IOP) was measured using the Goldmann applanation tonometer after 1 week and after 1, 3, and 6 months. Ocular hypertension was defined as an IOP elevation of 25% while on topical steroid treatment (minimum 28 mm Hg) followed by an IOP drop of 25% when steroid treatment was discontinued.

RESULTS

The study comprised 1783 patients (3566 eyes). The mean age of the patients was 26.95 years ± 7.56 (SD), and 54.85% were men. A total of 106 eyes (2.97%) were steroid responders. The responder group had a higher proportion of men than the nonresponder group (70.75% versus 29.25%; P 6.0 D) (31.13% versus 22.18%; P = .03), and higher rate of postoperative corneal haze (16.98% versus 4.25%; P < .001) and were treated postoperatively with more potent steroids. All factors remained significant in the multivariate analysis.

CONCLUSION

Significant factors associated with post-PRK ocular hypertension were male sex, high CCT, a low mean K reading, high myopia, corneal haze, and treatment with stronger steroids such as dexamethasone.