Purchase this article with an account.
J. T. Kuryan, J. Rosenberg, A. Madu; Risk Factors for Elevated Intraocular Pressure After Pterygium Excision. Invest. Ophthalmol. Vis. Sci. 2009;50(13):903.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Patients undergoing pterygium surgery at our institution have demonstrated postoperative intraocular pressure (IOP) elevations at rates higher than previously published from steroid response alone. We aim to quantify numbers of patients with ocular hypertension (OHTN) and identify possible risk factors contributing to IOP elevation following routine pterygium excision at a large academic institution in Bronx, New York.
Via retrospective chart review, we identified pterygium excisions performed by residents from April 2006 to October 2008. Patients were included if preoperative, intraoperative, and postoperative reports were available. For the 37 eyes of 36 patients identified, we reviewed IOP preoperatively and 1 day, 1 week, and 1 month postoperatively. Additional data extracted included cup-to-disc ratio, horizontal diameter of the pterygium, type of anesthetic block used, use of mitomycin-C (MMC), use of suture versus fibrin glue to secure the graft, use of a corneal burr, and type of steroid used postoperatively. Our primary endpoint was an increase in IOP greater than 5 mmHg from preoperative values or absolute IOP greater than 25 mmHg in the postoperative period. A paired t-test was used to compare preoperative and postoperative IOP. Fisher’s exact test was performed to assess for associations between possible risk factors and IOP rise.
Of 37 eyes, 11 (30%) demonstrated an elevated IOP during the postoperative period. Eight of 37 (22%) eyes had an IOP greater than 25 mmHg during the postoperative period. Seven of 37 (19%) eyes had an increase in IOP greater than 10 mmHg from preoperative values. Statistical analyses comparing preoperative mean IOP with postoperative values showed a statistically significant rise in IOP on postoperative day 1 (meanpreop= 14.91, meanpostop= 17.64, p=0.009), postoperative week 1 (meanpreop= 14.22, meanpostop=16.04, p = 0.002), and postoperative month 1 (meanpreop= 15.48, meanpostop= 18.56, p= 0.03). Patients in whom MMC was applied during the surgery had a trend toward lower rates of OHTN (5/23 vs. 7/14, p=0.15), but none of the factors studied were statistically significant.
This PDF is available to Subscribers Only