Incidence of Steroid-Induced Ocular Hypertension Following Myopic Refractive Surgery.
10.3341/jkos.2015.56.7.1081
- Author:
Sang Myung KIM
1
;
Hyoung Won BAE
;
Sung Yong KANG
;
Sa Min HONG
;
Gong Je SEONG
;
Chan Yun KIM
Author Information
1. The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. kcyeye@yuhs.ac
- Publication Type:Original Article
- Keywords:
Myopic refractive surgery;
Steroid induced ocular hypertension
- MeSH:
Glaucoma;
Humans;
Incidence*;
Intraocular Pressure;
Keratomileusis, Laser In Situ;
Lenses, Intraocular;
Medical Records;
Ocular Hypertension*;
Refractive Surgical Procedures*;
Retrospective Studies
- From:Journal of the Korean Ophthalmological Society
2015;56(7):1081-1088
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To determine the incidence of steroid-induced ocular hypertension following myopic vision correction. METHODS: This study retrospectively reviewed the medical records of 6,087 patients (12,164 eyes) who underwent myopic refractive surgery (laser-assisted in-situ keratomileusis [LASIK]/photorefractive keratectomy [PRK]/phakic intraocular lens [IOL] implantation) at Eyereum Eye Clinic between July 2011 and February 2013. Ocular hypertension was defined when post-operative intraocular pressure (IOP) was increased more than 30% compared to predicted IOP adjusted according to corneal thickness. All preoperative IOPs were measured using Goldmann applanation tonometer (GAT). Postoperative IOPs were measured using non-contact tonometer first and with GAT when the IOP was suspiciously increased. RESULTS: Steroid-induced ocular hypertension after a myopic refractive surgery occurred in 680 eyes (5.58%) of 404 patients (6.64%). The incidence based on surgery was LASIK (0.06%, 2/3, 514 eyes) followed by PRK (7.63%, 575/7,533 eyes) and phakic IOL implantation (9.2%, 103/1,117 eyes). The average increased IOP level in patients with steroid-induced ocular hypertension was 5.62 +/- 3.73 mm Hg after PRK and 9.35 +/- 4.95 mm Hg after phakic IOL implantation. A statistically significantly higher change in IOP was observed in the phakic IOL group (p < 0.001). However, the PRK group had a longer treatment period for ocular hypertension and used more antiglaucoma medications than the phakic IOL group (p < 0.05). Most patients with ocular hypertension were successfully treated with cessation of topical steroid or use of antiglaucoma medications. Only 2 eyes required glaucoma surgery because IOP was not controlled. CONCLUSIONS: IOP measurements should be initiated no later than 1 week after surgery because steroid-induced ocular hypertension following myopic refractive surgery can occur in approximately 5.58% of patients and most cases of ocular hypertension can be controlled with careful follow-up and use of antiglaucoma medications.
