Prevalence of Ocular Hypertension After Refractive Vision Correction for Myopic Astigmatism

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Jin Young Choi, MD, Eyereum Eye Clinic, Seoul, South Korea
David Sung Yong Kang, MD, Eyereum Eye Clinic, Seoul, South Korea
Chan Yun Kim, MD, PhD, Institute of Vision research, Yonsei University College of Medicine, Seoul, South Korea
Eun Suk Lee, MD, Seran Eye Center, Seoul, South Korea

Narrative Responses:

Purpose
To determine the incidence of steroid induced ocular hypertension following myopic vision correction.

Methods
Retrospective Comparative Interventional Case Series.Vision correction was performed on 12,164 eyes of 6087 patients between July, 2011 and February 2013. Femtosecond Laser assisted keratomilieusis(LASIK), photorefractive keratectomy(PRK) and phakic lens implantations were performed. The prevalence, onset, nature and duration of postoperative intraocular pressure (IOP) rise were analyzed for each surgical group. Also, the number and duration of anti-hypertensive medication use required to control steroid induced ocular hypertension were analyzed.

Results
Ocular hypertension developed in 679 eyes (5.58%) of 404 patients (6.64%). LASIK resulted in the least IOP rise (2/3321;0.06%. Average: 5;Range3–7mmHg). PRK showed an average IOP rise of 4.8 mmHg(51%; Range:1-25.4mmHg) in 575 eyes (7.63%). Phakic lens implantation showed an average IOP rise of 6.7mmHg(56%; Range:1-26mmHg) in 103 eyes (9.2%). PRK, Femto LASIK and phakic lens implantation eyes required 70.4, 6.7 and 31.4 days of topical treatment with anti-hypertensives respectively, using on average 1.9, 2 and 1.7 number of medications. There was no correlation between the level of IOP rise and pre-operative refractive error, central corneal thickness nor OCT parameters.

Conclusion
Topical steroids may cause ocular hypertension following refractive surgery. Early detection, prompt treatment and close follow up are recommended.