Higher incidence of steroid-induced ocular hypertension in keratoconus. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Kanellopoulos, Anastasios; Cruz, Emerson; Ang, Robert; Asimellis, George
• Is Part Of: Eye and vision. Volume 3:Issue 1(2016)
• Page Start: 1
• Page End: 8
• Publication Date: 2016-12
• Subjects: Keratoconus -- Intraocular pressure -- Corticosteroid induced ocular hypertension -- IOP spike -- Corneal collagen cross-linking -- CXL -- The Athens protocol -- Topography-guided -- Photorefractive keratectomy -- Dexamethasone topical ophthalmic solution; Ophthalmology -- Periodicals; Vision -- Periodicals; Optometry -- Periodicals; 617.7
• DOI: 10.1186/s40662-016-0035-9
• Languages: English
• ISSNs: 2326-0254

Abstract

Abstract Background To compare intraocular pressure (IOP) changes following topical dexamethasone administration for 1 month in keratoconic versus normal eyes. Methods This is a retrospective, single-center, non-randomized case series evaluation of 350 eyes. Two groups were formed: normal/control Group A (nA =73), eyes that underwent excimer laser photorefractive keratectomy; and keratoconic (KCN) Group B (nB =277), eyes that were subjected to partial laser photorefractive keratectomy combined with collagen cross-linking (The Athens Protocol). All eyes received the same post-operative regimen of topical dexamethasone 0.1 % for at least 1 month. Goldmann applanation tonometry IOP readings and central corneal thickness (CCT) measurements were monitored. Cases with induced ocular hypertension (OHT, defined as post-operative IOP higher than 21 mmHg), were identified and correlated to refractive procedure, gender, and corneal thickness. Results At 4 weeks postoperatively, OHT was noted on 27.4 % (20 /73 eyes) in Group A, and 43.7 % (121 /277 eyes) in KCN Group B, (p <0.01). Six months post-operatively (following 5-months of discontinuing topical dexamethasone treatment and commencing treatment of IOP-lowering medications), OHT rate was 1.8 % in Group A and 3.9 % in the KCN Group B. Conclusion This study demonstrates a potentially significant pre-disposition of keratoconic eyes to the development of steroid-induced OHT.