PURPOSE: To investigate the medical characteristics of patients who are steroid
responders and the timing of intraocular pressure (IOP) elevation after local
steroid treatment initiation and IOP resolution after treatment
discontinuation.
MATERIALS AND METHODS: All patients undergoing cataract surgery
in our department during a one-year period, which met the inclusion criteria,
were enrolled.
Patients were treated post operatively with local Dexamethasone using a
standard protocol. IOP measurements were taken before surgery and at preset
time intervals after it. IOP of 21 mmHg or more or increase in IOP of 5 mmHg or
more were considered steroid responsiveness.
RESULTS: Two hundred fifty one patients were enrolled. Fifty-seven (23.6%) were
identified as steroid responders.
IOP rise appeared at week 3-5 in most (47/57) cases. IOP returned to
normal in most cases (51/57) within 2-3 weeks from steroid discontinuation.
Primary open angle glaucoma in the patient or in a first degree relative
of his, Diabetes Mellitus and myopia of 4 diopters or more were more prevalent
in the steroid responders group.
Ischemic heart disease and systemic beta-blocker treatment were more
prevalent in the non-responders group.
CONCLUSIONS: Three weeks post local steroid treatment
initiation is the most prevalent time for IOP rise to appear. Risk factors for
steroid responsiveness found by us resemble previous knowledge in the
literature.
Systemic beta-blocker treatment has a “protective” effect against
steroid responsiveness. Special attention should be paid to patients treated
by systemic beta-blocker while
prescribing them local steroids as their responsiveness might be partially
“hidden”.