Incidence and risk factors for postoperative intraocular pressure response to topical prednisolone eye drops in patients undergoing phacoemulsification

Rajendrababu, Sharmila; Pallamparthy, Srilekha; Arunachalam, Anusha; Uduman, Mohammed Sithiq; Senthilkumari, Srinivasan; Krishnadas, Subbaiah Ramasamy; Senthilkumar, Vijayalakshmi A

doi:10.1007/s10792-021-01972-1

Cited by 5 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our model discovers that these two drugs may have a strong relationship with the abnormally increased intraocular pressure. This is highly consistent with medical literature [3,29,41,46] and clinician experience, which confirm that the two drugs can lead to adverse reactions like elevation of IOP and should be used with caution for specific patients in clinical practice.…”

Section: Discussionsupporting

confidence: 87%

M3Care: Learning with Missing Modalities in Multimodal Healthcare Data

Zhang

Chu

et al. 2022

Proceedings of the 28th ACM SIGKDD Conference on Knowledge Discovery and Data Mining

View full text Add to dashboard Cite

Multimodal electronic health record (EHR) data are widely used in clinical applications. Conventional methods usually assume that each sample (patient) is associated with the unified observed modalities, and all modalities are available for each sample. However, missing modality caused by various clinical and social reasons is a common issue in real-world clinical scenarios. Existing methods mostly rely on solving a generative model that learns a mapping from the latent space to the original input space, which is an unstable ill-posed inverse problem. To relieve the underdetermined system, we propose a model solving a direct problem, dubbed learning with Missing Modalities in Multimodal healthcare data (M 3 Care). M 3 Care is an end-to-end model compensating the missing information of the patients with missing modalities to perform clinical analysis. Instead of generating raw missing data, M 3 Care imputes the task-related information of the missing modalities in the latent space by the auxiliary information from each patient's similar neighbors, measured by a task-guided modality-adaptive similarity metric, and thence conducts the clinical tasks. The taskguided modality-adaptive similarity metric utilizes the uncensored modalities of the patient and the other patients who also have the * Both authors contributed equally to this research.

show abstract

Section: Discussionsupporting

confidence: 87%

M3Care: Learning with Missing Modalities in Multimodal Healthcare Data

Zhang

Chu

et al. 2022

Proceedings of the 28th ACM SIGKDD Conference on Knowledge Discovery and Data Mining

View full text Add to dashboard Cite

show abstract

“…19,32,37,38 Other studies have previously also identified younger age, male sex, and higher axial length as additional risk factors for steroid response. [19][20][21]38 We did not find these characteristics to be risk factors for steroid response, and by far the most significant risk factor was a prior diagnosis of glaucoma. Of note, however, over 50% of patients with steroid response in our study had an axial length greater than 24.5 mm, and the highlighted case of bilateral severe IOP elevation involved a highly myopic patient with axial length exceeding 28 mm in each eye.…”

mentioning

confidence: 56%

“…The outcome of interest was steroid response, defined as IOP 50% above baseline or IOP >24 mmHg in the postoperative period, excluding the first 72 hours. Although there is no consensus definition of steroid response in the literature, [19][20][21] we defined steroid response as either a 50% increase in postoperative IOP above baseline or IOP greater than 24 mmHg, as this IOP cutoff has previously been used in major trials including the Ocular Hypertension Treatment Study. 22 Our definition tries to capture steroid response in a way that includes significant increases in pressure for any particular case, including both patients with low baseline IOP (50% increase) as well as patients with a higher baseline IOP, in whom an increase that is less than 50% above baseline would nonetheless be clinically meaningful (eg, an increase to 28 mmHg from a baseline IOP of 20 mmHg, which is technically not a 50% increase).…”

Section: Outcomementioning

confidence: 99%

Steroid Response Following Dropless Cataract Surgery Using Subconjunctival Triamcinolone

Wu,

Pitts,

Pineda

et al. 2023

OPTH

View full text Add to dashboard Cite

To assess the rates of postoperative steroid response following dropless cataract surgery using a subconjunctival depot of triamcinolone versus conventional cataract surgery using topical prednisolone. Patients and Methods: We reviewed consecutive cataract surgery cases performed by a single surgeon to determine the likelihood of steroid response, defined as intraocular pressure (IOP) 50% above baseline or IOP > 24 mmHg postoperatively, excluding the first 72 hours. Logistic regression models were performed including baseline characteristics as exposures in the model and steroid response as the outcome. Main outcome measures were the proportion of eyes developing steroid response, risk factors for developing steroid response, and duration of steroid response. Results: Of the 150 dropless and 218 conventional cases, 26 eyes developed steroid response (15 dropless and 11 conventional cases [10% vs 5%, P=0.096]). Risk factors for steroid response included dropless surgery (OR=2.43, 95% CI=1.03-6.02], P=0.046) and prior diagnosis of glaucoma (OR=7.18, 95% CI=2.66-19.22], P<0.001). Baseline IOP, age, sex, race, and axial length did not increase risk for steroid response. Of the eyes with steroid response, more dropless cases had an IOP elevation ≥30 days (9/15 eyes vs 1/11 eyes; P=0.008), including one patient with refractory IOP elevation in the dropless group who required urgent bilateral trabeculectomy for IOP control. Conclusion: Dropless cataract surgery increases the risk of prolonged steroid response postoperatively. Patients with glaucoma have an increased risk of steroid response and may not be good candidates for dropless cataract surgery with subconjunctival triamcinolone.

show abstract

“…Topical corticosteroids increased the incidence of IOP spikes within 3 months after gonioscopy-assisted transluminal trabeculotomy [ 32 ]. In another report, the incidence of postoperative steroid responders was relatively low, but younger age and a higher AL were risk factors for a steroid response after cataract surgery [ 33 ]. The risk of postoperative IOP elevation after phaco-LOT and the relationship thereof with AL warrants further examination.…”

Section: Discussionmentioning

confidence: 99%

The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

Goto,

Honjo,

Omoto

et al. 2023

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

Purpose Minimally invasive glaucoma surgery is safer and effective surgical modality for patients with glaucoma. To compare the effect of axial length (AL) on the surgical outcomes of combined cataract surgery and ab interno trabeculotomy (phaco-LOT), a retrospective, non-randomized comparative study was performed. Methods In total, 458 eyes of 458 open-angle glaucoma patients who underwent phaco-LOT and were followed-up without any intervention for at least 6 months were enrolled. All were divided into a long-AL group (AL ≥ 26.0 mm, 123 eyes) and a not-long-AL group (AL < 26.0 mm, 335 eyes). The principal outcomes were the changes in intraocular pressure (IOP) and medication scores. We also sought a correlation between postoperative IOP spike and hyphema. Results Significant postoperative reductions in IOP and medication scores were apparent in all subjects. The IOP reductions were significant at all timepoints in the not-long-AL group, but not until 1 month postoperatively in the long-AL group, and the IOP change was significantly lower in the long-AL group from postoperative day 1 to 3 months. On subanalysis of subjects by age, the microhook used, the pre-operative IOP, and the medication score, a significantly higher incidence of IOP spike was observed in the long-AL group in weeks 1 and 2 (both p < 0.05), but this did not correlate with hyphema status, implying that a different mechanism was in play. Conclusion Phaco-LOT was effective regardless of AL, but the postoperative IOP decrease was lower and the early postoperative incidence of IOP spike was higher in long-AL eyes.

show abstract

Incidence and risk factors for postoperative intraocular pressure response to topical prednisolone eye drops in patients undergoing phacoemulsification

Cited by 5 publications

References 31 publications

M3Care: Learning with Missing Modalities in Multimodal Healthcare Data

M3Care: Learning with Missing Modalities in Multimodal Healthcare Data

Steroid Response Following Dropless Cataract Surgery Using Subconjunctival Triamcinolone

The effect of axial length on the short-term outcomes of cataract surgery combined with ab interno trabeculotomy

Contact Info

Product

Resources

About