Risk factors predicting steroid-induced ocular hypertension after photorefractive keratectomy.
Busool Yumna, Mimouni Michael, Vainer Igor, Levartovsky Shmuel, Sela Tzahi, Munzer Gur, Kaiserman Igor
AI Summary
This study identified male sex, high central corneal thickness, low mean keratometry, high myopia, corneal haze, and potent steroids as risk factors for ocular hypertension after PRK, guiding personalized post-operative care.
Abstract
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 < .001), higher central corneal thickness (CCT) (531.9 ± 40.2 μm versus 521.2 ± 40.9 μm; P = .008), lower mean keratometry (K) power (43.39 ± 1.84 diopters [D] versus 44.08 ± 1.88 D; P < .001), higher proportion of high myopia (>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.
MeSH Terms
Shields Classification
Key Concepts6
A retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK) between January 2000 and December 2015 found that 106 eyes (2.97%) developed steroid-induced ocular hypertension.
In a retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK), male sex was significantly associated with steroid-induced ocular hypertension (70.75% in responders versus 29.25% in nonresponders; P < .001).
A retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK) identified higher central corneal thickness (CCT) (531.9 ± 40.2 μm in responders versus 521.2 ± 40.9 μm in nonresponders; P = .008) as a significant risk factor for steroid-induced ocular hypertension.
In a retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK), a lower mean keratometry (K) power (43.39 ± 1.84 diopters [D] in responders versus 44.08 ± 1.88 D in nonresponders; P < .001) was significantly associated with steroid-induced ocular hypertension.
A retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK) found that high myopia (>6.0 D) was a significant risk factor for steroid-induced ocular hypertension (31.13% in responders versus 22.18% in nonresponders; P = .03).
In a retrospective case series of 1783 patients (3566 eyes) who underwent photorefractive keratectomy (PRK), postoperative corneal haze (16.98% in responders versus 4.25% in nonresponders; P < .001) and treatment with more potent steroids (e.g., dexamethasone) were significant risk factors for steroid-induced ocular hypertension.
Related Articles5
Incidence and Risk Factors of Elevated Intraocular Pressure Following Deep Anterior Lamellar Keratoplasty.
Case SeriesRisk factors for steroid response among cataract patients.
Case-Control StudyComparison of Intraocular Pressure, Usage of Topical Steroids, Need for Intraocular Pressure Lowering Drops, and Incidence of Glaucoma Surgery Up to 2 Years After Penetrating Keratoplasty and Endothelial Keratoplasty.
Cohort StudyInterface fluid after LASIK: misleading tonometry can lead to end-stage glaucoma.
Case ReportIncreased intraocular pressure with corticosteroid medication after photorefractive keratectomy.
Case ReportIs this article assigned to the wrong chapter(s)? Let us know.