Abstract
Purpose: :
To report intraocular pressure spikes in a consecutive series of 100 uncomplicated postoperative cataract patients using difluprednate ophthalmic emulsion 0.05% bid after surgery.
Methods: :
Retrospective chart review was performed for patients with 5mm Hg or more elevation compared to baseline intraocular patients.
Results: :
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.
Conclusions: :
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.
Keywords: drug toxicity/drug effects • cataract • anterior segment