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Marked intraocular pressure response to instillation of corticosteroids in children
1Department of Ophthalmology, Osaka University Medical School, Japan.
Insights
Corticosteroid eyedrops like dexamethasone can increase intraocular pressure in children under 10 after strabismus surgery. This effect was less pronounced with fluorometholone or in older patients.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Strabismus surgery requires careful postoperative management to prevent complications.
- Corticosteroids are commonly used postoperatively but can affect intraocular pressure (IOP).
Purpose of the Study:
- To evaluate the impact of different corticosteroid eyedrops on intraocular pressure in pediatric patients post-strabismus surgery.
- To identify potential risk factors for elevated IOP in response to corticosteroid treatment.
Main Methods:
- A study involving three groups of patients undergoing strabismus surgery.
- Group A: 11 children (<10 years) received 0.1% dexamethasone eyedrops.
- Group B: 9 patients (≥10 years) received 0.1% dexamethasone eyedrops.
- Group C: 13 children (<10 years) received 0.1% fluorometholone eyedrops.
Main Results:
- In Group A, a significant number of patients (9/11) experienced elevated IOP (>20 mm Hg) within 1-2 weeks postoperatively.
- All patients in Group A showed a decrease in IOP to <21 mm Hg one week after discontinuing dexamethasone.
- No patients in Group B (older patients) or Group C (fluorometholone) exhibited IOP >20 mm Hg.
Conclusions:
- Children under 10 years of age are particularly susceptible to a marked ocular hypertensive response to 0.1% dexamethasone eyedrops post-strabismus surgery.
- Age and the specific corticosteroid used (dexamethasone vs. fluorometholone) are critical factors influencing IOP changes after strabismus surgery.
Abstract:
We examined intraocular pressures of patients with strabismus whose eyes were instilled with corticosteroid eyedrops after a strabismus operation. Group A consisted of 11 children under 10 years of age whose eyes were instilled with 0.1% dexamethasone; Group B consisted of nine patients 10 years old or older whose eyes were instilled with 0.1% dexamethasone; and Group C consisted of 13 children under 10 years of age whose eyes were instilled with 0.1% fluorometholone. In Group A, four patients had intraocular pressures greater than 30 mm Hg, five had intraocular pressures from 21 to 30 mm Hg, and two had intraocular pressures under 21 mm Hg one or two weeks postoperatively. The intraocular pressure decreased to less than 21 mm Hg one week after discontinuation of dexamethasone treatment in all nine patients. No patients in Groups B or C had intraocular pressures greater than 20 mm Hg. Our results suggest that marked ocular hypertensive response to 0.1% dexamethasone treatment occurs frequently in children under 10 years of age.