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Incidence and risk factors for postoperative intraocular pressure response to topical prednisolone eye drops in patients undergoing phacoemulsification

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Abstract

Aim/purpose

To report the incidence, risk factors, and magnitude of steroid response in individuals receiving topical 1% prednisolone acetate eye drops following phacoemulsification surgery

Materials and methods

Postoperative IOP of 1118 consecutive patients who had uneventful cataract surgery and used 1% topical prednisolone acetate were studied. Baseline ocular parameters like best-corrected visual acuity, IOP, and slit-lamp examination findings were noted preoperatively and at postoperative day 30. Incidence of postoperative intraocular pressure response to steroid was analyzed and graded as mild, moderate, or severe and risk factors studied.

Results

The mean age of our study cohort was 59.49 ± 7.25 years. The overall incidence of steroid response was 3.2%, (2.8% being moderate responders, and 0.4% high responders). Mean preoperative IOP was 14.67 ± 2.2 mm Hg in the study cohort (n = 1118). Mean postoperative IOP was 21.33 ± 7.97 mm Hg in the steroid responder (SR) and 14.66 ± 2.8 mm Hg in the non-responder (NR), with a statistically significant difference from the baseline IOP in the SR group (p < 0.001) and no difference in the NR. Univariate analysis revealed younger age and high axial length as risk factors but on multiple regression analysis, only younger age < 50 years was found to be a significant risk factor for steroid response.

Conclusion

The overall steroid response in this population post-cataract surgery was low with most being moderate responders. Younger age and higher axial length were identified as risk factors for steroid response, and hence this warrants the judicious use of steroids in such individuals.

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Abbreviations

SR:

Steroid responders

NR:

Non-responders

GC:

Glucocorticoids

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Authors and Affiliations

  1. Department of Glaucoma Services, Aravind Eye Hospital, Madurai, Tamilnadu, 625020, India

    Sharmila Rajendrababu, Srilekha Pallamparthy, Anusha Arunachalam, S. R. Krishnadas & Vijayalakshmi A. Senthilkumar

  2. Department of Biostatistics, Aravind Eye Hospital, Madurai, Tamilnadu, India

    Mohammed Sithiq Uduman

  3. Department of Ocular Pharmacology, Aravind Medical Research Foundation, Madurai, Tamilnadu, India

    Senthilkumari Srinivasan

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  1. Sharmila Rajendrababu
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  2. Srilekha Pallamparthy
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Correspondence to Sharmila Rajendrababu.

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Rajendrababu, S., Pallamparthy, S., Arunachalam, A. et al. Incidence and risk factors for postoperative intraocular pressure response to topical prednisolone eye drops in patients undergoing phacoemulsification. Int Ophthalmol 41, 3999–4007 (2021). https://doi.org/10.1007/s10792-021-01972-1

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