Risk factors for early onset elevated intraocular pressure after pterygium surgery

Abstract

PurposeIn this study, we aimed to identify the risk factors for early postoperative elevation of intraocular pressure (IOP) after pterygium surgery.Patients and methodsAll patients in this retrospective cohort study were evaluated for inclusion from a single tertiary care center at Boston Medical Center. Their pre- and postoperative IOP measurements (day 1, week 1, month 1, month 3, and when clinically necessary) were compared. Patients with postoperative IOP measurement of >22 mmHg or with an increase in IOP by ≥10 mmHg compared with the preoperative measurement value were grouped as “Ocular Hypertension” group; otherwise, patients were grouped in the “No Ocular Hypertension” group. Age, sex, race, baseline IOP, cup-to-disc (C/D) ratio, history of glaucoma, and frequency of use of postoperative steroid drops in all patients were compared. Chi square test was performed to compare the categorical variables, whereas Student’s t-test was performed to compare continuous variables. We performed a multivariate logistic regression analysis of categorical data with a significance level of p < 0.05.ResultsIn total, 240 patient charts were reviewed for inclusion in this study. Twenty-six patients required pterygium surgery on both eyes; for these patients, the eye with higher IOP was analyzed. Two patients were discontinued from this study because of elevated IOP in the contralateral, nonsurgical eye. Fortyeight out of 212 eyes (22.64%) developed postsurgical elevation of IOP within the first 3 months of operation. No significant differences were found between age, sex, baseline IOP, C/D ratio, history of glaucoma diagnoses, and frequency of use of postoperative steroid drops. However, Hispanic/Latino race (p = 0.036) and lack of application of steroid ointment (p = 0.001) were found to be the significant risk factors for the development of “Ocular Hypertension” in multivariate analysis.ConclusionEarly elevation of IOP is a risk of pterygium surgery. One nonmodifiable risk factor, Hispanic/Latino race, and one modifiable risk factor, lack of application of steroid ointments, were identified as potential causes of early postoperative IOP elevation.

Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

“…The homogeneous patient demographic is both a strength and limitation. Although our study discloses similar findings on ocular hypertension and recurrence in Hispanic patients to those reported by Wu et al, 26 Fam et al, 27 and Kandavel et al, 38 generalizability is constrained by the homogeneous patient demographic. To enhance validity and broaden the application of this study, further investigations that include a more diverse population are needed.…”

“… 20 Our patient population was ethnically Hispanic, which is noted to be a risk factor with an incidence of greater than 22% of elevated IOP after pterygium surgery. 26 In addition, we hypothesize that our study had a higher percentage of patients with elevated IOP because the insert was placed in both the upper and lower puncta, versus solely in the lower punctum in the Phase 3 trial. In the present study, all patients had 2 months of steroid exposure which could have contributed to the elevated IOP.…”

Surgical Techniques and Adjuvants for the Management of Pterygium

“…Hispanic race may be a significant risk factor for developing ocular hypertension after pterygium surgery, with an incidence of over 22%. 74 With the intensity and duration of postoperative topical steroids required to prevent pterygium recurrence, patient compliance with eye drop instillation is often a challenge. Novel drug delivery systems can enhance bioavailability and offer controlled and sustained release of a drug.…”

“…Hispanic race may be a significant risk factor for developing ocular hypertension after pterygium surgery, with an incidence of over 22%. 74…”

The Effects of Self Reminder Card to the Successful Treatment of Blood Pressure of Hypertension Patients in Community Health Centers in Surabaya

“…This was also in accordance with the theory that stress was able to increase peripheral blood vessels and cardiac output so that it stimulated sympathetic nerve activity. (21) Characteristics of the study sample seen from the duration of being diagnosed with hypertension in the results of this study in the control and intervention groups were majority 1-5 years. The duration of hypertension had a relationship with the respondent's level of anxiety.…”