Steroid Induced Ocular Hypertension Following Myopic Photorefractive Keratectomy

Purpose: To determine the incidence of steroid induced ocular hypertension followingmyopic photorefractive keratectomy (PRK).Methods: Myopic PRK was performed on 506 eyes of 269 patients. Preoperatively,spherical equivalent refractive error ranged from -1.00 to -5.00 diopters (D) and cylinderwas less than 4 D. Baseline intraocular pressure (IOP) before PRK and at different timeintervals after the procedure was measured by Goldmann applanation tonometry. IOPreadings were corrected according to central corneal thickness as measured by Orbscanpachymetry. For the purpose of the study, corrected IOP 21 mmHg was considered asocular hypertension.Results: Ocular hypertension developed in 40 (7.9%) eyes overall, which occurred in 16eyes (40%) 2-3 weeks postoperatively (mean IOP=23.5±3.0mmHg), in 20 eyes (50%) after4-6 weeks (mean IOP=25.1±4.2 mmHg) and in 4 eyes (10%) 8-12 weeks following PRK(mean IOP=29.0±3.1 mmHg). There was no correlation between the level of IOP rise andpreoperative spherical equivalent refractive error. IOP recovered to normal in all eyesafter discontinuation of topical steroids and initiation of anti-glaucoma medications.Mean duration of IOP normalization was 28.5±27.7 (range 7-108 ) days and no instanceof steroid-induced glaucoma was observed in any patient.Conclusion: Topical steroids may cause ocular hypertension following PRK. Earlydetec-tion, prompt treatment and close follow-up are recommended. We suggestmeasuring IOP in post-PRK patients no later than 10 to 14 days after initiation of corticosteroid treatment.