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Maria Husain, Anhtuan Nguyen, Kundandeep Nagi; Ocular Hypertension Profile after Pterygium Excision. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5629.
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The occurrence of steroid induced ocular hypertension (OHTN) is a well known phenomenon, though not clearly studied after pterygium surgery. This study aimed to look at the post-operative IOP profile and associated ocular hypertension or glaucoma after pterygium excision.
A retrospective chart review yielding 83 post pterygium excision eyes were included in the study. Demographic factors, visual acuity, pre and post-operative intraocular pressure (IOP), surgical technique, length and type of steroid use were recorded. Our endpoint was the development of ocular hypertension and/or glaucoma; in addition, we anticipate comparing these patients with age and sex matched post-operative cataract controls.
The average age of the all subjects was 55 (range 28-86). Among patients that developed OHTN (n=14, 16.9%) or glaucoma (n=1, 1.2%), the average age was 55.3 (range 35-79), and 33% were female. Those that developed OHTN had an average post-op IOP increase of 13.57 mmHg (STDEV 6.17, p<0.001) compared to nonresponders, occurring an average of 70.2 days post-op. The patient that developed glaucoma had a 19 mmHg increase in IOP postoperatively, occurring 170 days post-op. Subjects that developed increased IOP had a longer course of topical steroids compared to those that did not respond (144.92 days vs. 98.41 days, p=0.053); this difference approached statistical significance. An average of 1.60 IOP lowering medications was needed to treat the IOP, and no surgical intervention was required. 6 (35.29%) eyes that underwent amniotic membrane graft developed OHTN/glaucoma, and 9 (13.64%) eyes that had conjunctival autografting developed OHTN (p = .039).
Similar to literature examining post-operative IOP rises, our study finds that post-operative pterygium excision patients are at a significant risk to developing ocular hypertension. Development of a standard dosing regimen may blunt the incidence of vision threatening eye complications.
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