Long-term Outcomes on de novo Ocular Hypertensive Response to Topical Corticosteroids After Corneal Transplantation
| Autor: | Akash Raj, Borja Salvador-Culla, Hamed M. Anwar, E. Sykakis, Francisco C. Figueiredo, M. S. Figueiredo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Rimexolone
Adult Graft Rejection Male Keratoconus Intraocular pressure medicine.medical_specialty Visual acuity Time Factors genetic structures medicine.medical_treatment Visual Acuity Ocular hypertension Intraocular lens 03 medical and health sciences Tonometry Ocular Young Adult 0302 clinical medicine Ophthalmology medicine Humans Glucocorticoids Corneal transplantation Fluorometholone Intraocular Pressure Aged Retrospective Studies Aged 80 and over business.industry Incidence Graft Survival Middle Aged medicine.disease eye diseases United Kingdom 030221 ophthalmology & optometry Female Ocular Hypertension sense organs medicine.symptom Ophthalmic Solutions business 030217 neurology & neurosurgery Keratoplasty Penetrating medicine.drug Follow-Up Studies |
| Zdroj: | Cornea. 39(1) |
| ISSN: | 1536-4798 |
| Popis: | To determine incidence, demographics, management, and outcomes of topical steroid-induced ocular hypertension after penetrating keratoplasty (PKP) and to establish effects on intraocular pressure (IOP) and graft rejection when alternate corticosteroids are used.A single-center, retrospective review of 568 consecutive PKPs performed between 1997 and 2010 was conducted. Data were collected on demographics, best-corrected visual acuity, surgical indications, lens status, IOP, postoperative management, and incidence of rejection.Eighty eyes (14.1%) of 74 patients were included. The most common indication was keratoconus (28.8%). Twenty-seven eyes (33.8%) were phakic, 46 (57.4%) had a posterior chamber intraocular lens, and 7 (8.8%) had an anterior chamber intraocular lens. Mean postoperative IOP increase was only significant in the anterior chamber intraocular lens group (18.7 mm Hg, SD 10.4; P = 0.02). The average time for developing hypertension was 9.8 months (SD 14.8) postoperatively, with an average IOP increase of 13.3 mm Hg (SD 5.9). Prednisolone acetate 1% was switched to rimexolone 1% in 64 eyes (80%) and to fluorometholone 0.1% in 16 eyes (20%), which alone achieved IOP normalization in 26 eyes (32.5%) (P0.01). Fifty-four eyes (67.5%) required additional antiglaucoma medication. An average IOP reduction of 12.3 mm Hg (SD 6.9) was achieved at an average of 2.3 months (SD 5.2) after the switch. Seventeen eyes (21%) developed glaucoma and 13 eyes (16.3%) developed graft rejection after switching formulations, with no statistically significant differences between rimexolone and fluorometholone (P0.05).The use of alternate topical corticosteroids may be considered in cases of steroid-induced ocular hypertension after PKP because they offer good antiinflammatory prophylaxis with reduced hypertensive response. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|