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Karine D Bojikian, Priscilla Nobrega, Philip P Chen; Incidence and risk factors for steroid response after cataract surgery in patients with and without glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2432.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate incidence and risk factors for topical steroid response after uneventful cataract surgery in patients with and without glaucoma.
Retrospective review of consecutive normal and glaucoma patients without prior incisional glaucoma surgery undergoing cataract surgery from a single-surgeon between March 2007 and September 2016. All patients routinely received topical prednisolone acetate 1.0% postoperatively. Eyes with intraoperative complications such as hyphema, posterior capsule rupture, or vitreous loss were excluded from the analysis. Pertinent clinical information including demographic information, diagnosis subtypes, preoperative IOP, postoperative IOP at day 1, week 1 and at least 1 additional time between week 3 and week 5, disease severity indices, ophthalmic biometry and treatment measures was recorded. A steroid response was defined as an IOP > 50% greater than baseline while on topical prednisolone. Any IOP elevation during the first week was not counted. Univariate analysis was performed using 2-tailed t-test for continuous variables, and Pearson chi-square and Fisher’s exact test for categorical variables. One step Bonferroni was used for multiple comparison adjustment.
We included 385 eyes of 385 normal patients and 142 eyes of 142 glaucoma patients. Nine (2.3%) normal eyes and 17 (12.0%) glaucoma eyes were diagnosed as steroid responders (RR= 5.12, p<0.001). For normal patients, lower baseline IOP was associated with higher incidence of steroid response (P<0.001) (Table 1); for glaucoma patients, worse baseline LogMAR visual acuity (VA) was associated with higher incidence of steroid response (P=0.02) (Table 2).
Glaucoma patients were 5 times more likely to have steroid response to topical prednisolone acetate 1.0% after uneventful cataract surgery; worse baseline VA was associated with increased risk for steroid response among glaucoma patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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