J Korean Ophthalmol Soc > Volume 56(7); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(7):1081-1088.
DOI: https://doi.org/10.3341/jkos.2015.56.7.1081    Published online July 15, 2015.
Incidence of Steroid-Induced Ocular Hypertension Following Myopic Refractive Surgery.
Sang Myung Kim, Hyoung Won Bae, Sung Yong Kang, Sa Min Hong, Gong Je Seong, Chan Yun Kim
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. kcyeye@yuhs.ac
2Eyereum Eye Clinic, Seoul, Korea.
근시교정수술 후 발생한 스테로이드 유발 안압 상승의 발생률
김상명1⋅배형원1⋅강성용2⋅홍사민1⋅성공제1⋅김찬윤1
연세대학교 의과대학 안과학교실 시기능 개발연구소1, 아이리움 안과의원2
Received: 8 November 2014   • Revised: 22 January 2015   • Accepted: 20 May 2015
Abstract
PURPOSE
To determine the incidence of steroid-induced ocular hypertension following myopic vision correction. METHODS: This study retrospectively reviewed the medical records of 6,087 patients (12,164 eyes) who underwent myopic refractive surgery (laser-assisted in-situ keratomileusis [LASIK]/photorefractive keratectomy [PRK]/phakic intraocular lens [IOL] implantation) at Eyereum Eye Clinic between July 2011 and February 2013. Ocular hypertension was defined when post-operative intraocular pressure (IOP) was increased more than 30% compared to predicted IOP adjusted according to corneal thickness. All preoperative IOPs were measured using Goldmann applanation tonometer (GAT). Postoperative IOPs were measured using non-contact tonometer first and with GAT when the IOP was suspiciously increased. RESULTS: Steroid-induced ocular hypertension after a myopic refractive surgery occurred in 680 eyes (5.58%) of 404 patients (6.64%). The incidence based on surgery was LASIK (0.06%, 2/3, 514 eyes) followed by PRK (7.63%, 575/7,533 eyes) and phakic IOL implantation (9.2%, 103/1,117 eyes). The average increased IOP level in patients with steroid-induced ocular hypertension was 5.62 +/- 3.73 mm Hg after PRK and 9.35 +/- 4.95 mm Hg after phakic IOL implantation. A statistically significantly higher change in IOP was observed in the phakic IOL group (p < 0.001). However, the PRK group had a longer treatment period for ocular hypertension and used more antiglaucoma medications than the phakic IOL group (p < 0.05). Most patients with ocular hypertension were successfully treated with cessation of topical steroid or use of antiglaucoma medications. Only 2 eyes required glaucoma surgery because IOP was not controlled. CONCLUSIONS: IOP measurements should be initiated no later than 1 week after surgery because steroid-induced ocular hypertension following myopic refractive surgery can occur in approximately 5.58% of patients and most cases of ocular hypertension can be controlled with careful follow-up and use of antiglaucoma medications.
Key Words: Myopic refractive surgery;Steroid induced ocular hypertension


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