Intraocular pressure trend following myopic photorefractive keratectomy

Abstract

To evaluate the intraocular pressure (IOP) trend and risk factors for IOP rise after myopic photorefractive keratectomy (PRK). Patients and MethodsOne eye of each patient undergone PRK for myopia was randomly assigned to this study. All eyes underwent tonometry by CorVis Scheimp ug Technology (CST) tonometer (Oculus Optikgeräte GmbH, Wetzlar, Germany) 1 week, 2 weeks, 1 month, 2 months, 3 months and 4 months after surgery. The eyes with IOP rise more than 5 mmHg and the risk factors were evaluated by Kaplan-Meier graph and multiple Cox regression analysis.Results 348 eyes of 348 patients were enrolled in this study. Forty-three eyes (12.35%) experienced an IOP rise of more than 5 mmHg. Eyes with IOP rise had higher baseline IOP (Median 19 mmHg (IQR 18 -22) versus. Median 15 mmHg (IQR 14 -16); p< 0.001). Baseline central corneal thickness (CCT) was higher in eyes without IOP rise (Median 520 µm (IQR 509 -541) versus. Median 535 µm (IQR 518 -547); p= 0.009). in multivariate Cox regression analysis higher baseline IOP was a risk factor for IOP rise (Hazard Ratio (HR) 1.59 (95% CI 1.43 -1.77); p< 0.001) while higher baseline CCT was protective (HR 0.97 (95% CI 0.95 -0.98); p< 0.001). ConclusionEyes with higher baseline IOP and lower baseline CCT are at increased risk of IOP rise after PRK and should be monitored more frequently.

Transpalpebral intraocular pressure measured by Diaton tonometer before, 1 week, and 1 month after transepithelial photorefractive keratectomy in young myopic Saudi patients and its determinants

“…Higher baseline IOP was a risk factor for IOP >5 mmHg after TPRK in a study using a CorVis Scheimpflug Technology tonometer. [ 21 ] Eye health-care providers should note the importance of baseline IOP in selecting patients for refractive surgery and counsel them about the risk of high postoperative IOP and the need for more frequent follow-up visits to monitor and manage high IOP if needed. The trend of using topical steroids postoperatively is responsible for rise in IOP compared to the baseline.…”

Management and outcomes after Trans-Epithelium Photorefractive Keratectomy and Laser-Assisted Sub-Epithelium Keratectomy in the COVID-19 Epidemic

“…The factors correlated with postoperative hypertension of PRK are male sex, high central corneal thickness (CCT), low mean K reading, high myopia, corneal haze, and treatment with stronger steroids such as dexamethasone [16]. Another previous study showed that eyes with higher baseline IOP and lower baseline CCT are at increased risk of a rise in IOP after PRK and should be monitored more frequently [17]. Nevertheless, increased IOP was found later than usual, IOP was controlled as soon as possible after the administration of eye drops, and vision was unaffected.…”

Refractive surgery for the glaucoma suspect

“…Myopia is an independent risk factor for open-angle glaucoma (OAG) and steroid-induced OHTN [18,19]. A recent study of 348 eyes undergoing myopic PRK from Fakhraie et al [20 ▪▪ ] found that higher baseline IOP and lower baseline central corneal thickness (CCT) are significant risk factors for IOP rise after myopic PRK. Importantly, these authors found that the degree of myopia was not a risk factor for IOP elevation, and there was no difference in the proportion of eyes with high myopia between the eyes with and without IOP elevation.…”

“…Accurate monitoring of postoperative IOP is of particular importance in patients undergoing myopic photorefractive keratectomy (PRK) who are found to have higher baseline IOP and lower baseline CCT [20 ▪▪ ]. More frequent monitoring should be considered for these patients.…”