Abstract
Purpose: :
To report rates and timing of intraocular pressure spikes in open angle glaucoma patients undergoing uncomplicated phacoemulsification by one surgeon using difluprednate ophthalmic emulsion 0.05% bid or qd postoperatively.
Methods: :
Retrospective chart review of 200 consecutive uncomplicated patients previously diagnosed with open angle glaucoma.
Results: :
Of 200 consecutive phacoemulsification patients 14 were identified by electronic medical records as open angle glaucoma. Of the 14, 7 or 50% responded with intraocular pressure spikes of 10 mm Hg or more within the first postoperative week. None had a history of previous steroid response. 4 patients in the bid group and 3 patients in the qd group experienced intraocular pressure spikes. All spikes occurred on pod1 except one spike in the qd group which occurred on pod7.
Conclusions: :
Steroid response occurs in 4-8% of the general population and up to 95% in open angle glaucoma patients when exposed to steroid for up to 6 weeks. Difluprednate is a strong topical steroid. It may cause early and significant elevations of intraocular pressure when used postoperatively. Intraocular pressure elevations may be more likely in open angle glaucoma patients using difluprednate even if they are not known steroid responders.
Keywords: corticosteroids • treatment outcomes of cataract surgery • cataract