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Study identifies risk factors for steroid-induced hypertension after PRK
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Male sex, high myopia, higher central corneal thickness, lower K value, corneal haze, type of steroid used and length of therapy were associated with a higher risk of steroid-induced ocular hypertension after PRK surgery, a study showed.
The data from 3,566 eyes of 1,783 patients who had PRK with five different surgeons were retrospectively analyzed. Different steroid regimens were prescribed after surgery, with either dexamethasone or fluorometholone or both consecutively. The schedule was one drop every 6 hours for all, but length of treatment varied between 2 and 8 weeks. Ocular hypertension, defined as IOP elevation of 25% during steroid treatment and return to baseline after discontinuation, occurred in 106 eyes (2.97%).
Several factors were found in this study to be predictive of ocular hypertension. In agreement with other studies, high myopia appeared to increase the chances of abnormal IOP elevation.
Male gender, higher central corneal thickness and lower preoperative mean K were other factors. A correlation was found with the type of steroid used. Dexamethasone, a more potent steroid, was associated with a higher steroid response than fluorometholone, and it further increased when the duration of treatment was longer (6 weeks vs. 4 weeks). Patients treated with fluorometholone only experienced no ocular hypertension.
An association was also found with haze, because patients with haze were treated with a more aggressive steroid regimen.
The authors stated that, to their knowledge, this study was the first to investigate the risk factors associated with steroid-induced ocular hypertension after PRK.
“These risk factors might help [eye care practitioners] determine which individuals merit closer observation or alternative anti-inflammatory pharmacological approaches,” they concluded. – by Michela Cimberle
Disclosure: None of the authors has a financial or proprietary interest in any material or method mentioned.
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