Incidence of steroid induced-ocular hypertension in postoperative pterygium excision

Steroid eye drops were widely used for suppression ocular inflammation in many conditions. Unfortunately, steroid eye drops can cause many side effects; the important one was steroid-induced ocular hypertension that may progress to seconday glaucoma.

To evaluate incidence ofsteroid responder following topical dexamethasone use after pterygium excision with amniotic membrane graft.

Prospective descriptive study.

The present study was designed to evaluate intraocular pressure (IOP) change from topical dexamethasone eye drops in postoperative pteiygium excision with amniotic membrane grafting. The subjects were routinely prescribed CD-oph (1 mg/ml dexamethasone sodium phosphate, 5 mg/nd chloramphenicol and 0.25 mg/ml Tetrahydrozaline hydrochloride) eye drops every 1 hour for 1 week, then every 2 hours until 1 month, then four times daily until 3 months postoperatively. The subjects were measured IOP at I week, 1 month, and 3 month postoperatively by applanation tonometer The steroid responder was defined as an elevation ofIOP at least 10 mmHgfrom preoperative. The incidence was calculated, trend of IOP rising and timing of peak IOP were assessed.

Ofthe 62 patients, 6 were diagnosed as steroid responders (IOP >10 mmHg), 9.68% (95% CI 3.6-19.9). Mean of peak IOP rising was 4.02+/-3.18 mmHg with maximum IOP rising was 11 mmHg. 4 of 6 cases of steroid responders occur at 3 month postoperative, 2 another cases occur at 1 week and I month postoperative. Most of the subjects had IOP rising in range of 0-4 mmHg (62.90%), follow by 5-9 mmHg (2 7.42%), and > 10 mmHg (9.68%), respectively. Maximum IOP mostly in range of 16-20 mmHg (43.55%), follow by 11-15 mmHg (40.32%), 21-25 mmHg (9.68%), and more than 26 mmHg (6.45%), respectively. 45.16% of subjects showed the time of peak lOP at postoperative 1 month.

Steroid response is a common problem in steroid use, especially with topical steroid eye drops. The incidence of steroid responderfrom this study was 9.68%, which may differ from the others by type, frequency of the topical steroid used, including criteria to diagnosis of steroid responder