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M. M. Cable; Intraocular Pressure Spikes Using Difluprednate 0.05% for Postoperative Cataract Inflammation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1981.
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© ARVO (1962-2015); The Authors (2016-present)
To report intraocular pressure spikes in a consecutive series of 100 uncomplicated postoperative cataract patients using difluprednate ophthalmic emulsion 0.05% bid after surgery.
Retrospective chart review was performed for patients with 5mm Hg or more elevation compared to baseline intraocular patients.
In a series of 100 uncomplicated phacoemulsification patients receiving bid dosing of difluprednate, average age 74.4 years, men and women, 5% of patients responded with ocular hypertension. Of those, 100%were previously diagnosed with open angle glaucoma. Average baseline IOP was 17.8 mm Hg, average maximal IOP was 35.4 mm Hg with a range of 28-44. Average increase in IOP was 17.8 mm Hg, with an average percentage increase over baseline of 100.2%. 60% of IOP spikes were noted on POD1, 40% by POD7. Iop was managed by discontinuation of Durezol and/or addition of topical glaucoma meds. All patients responded to treatment quickly returning to baseline within 1-2 days.
Difluprednate given bid in uncomplicated phacoemulsification patients can cause significant and early elevations of IOP. Reported rates of ocular hypertension in bid dosing of difluprednate is 3-4%. The rate of OHTN in this series was 5% with 100% of responders having a history of OAG. Patients with a history of OAG may be more likely to respond to difluprednate even if they are not known steroid responders.
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