Study of prevalence of raised IOP in post cataract patients following topical steroid usage

Abstract

To evaluate the rise in intraocular pressure (IOP) in post cataract surgery patients who received topical steroids.Patients in the age group of 50-75 years and both sexes who were coming to ophthalmology OPD at a tertiary care hospital of Western Maharashtra were studied. 500 subjects who underwent uncomplicated cataract surgery were taken into consideration; both age and sex matched. All patients were screened for raised intraocular pressure by Perkin’s tonometer preoperatively and at 5th day, 2nd week, 4th week, 6th week and 8th week postoperatively. Patients were allocated into two groups: either topical Prednisolone acetate e/d (1%) (Group I) or Dexamethasone e/d (0.1%) (Group II) started six times for 1st week (considering the cells in anterior chamber <2+) & then tapered off subsequently in the following weeks for a period of 5 weeks (starting with six times for 1st week, then tapering to 4 times for the next week, 3 times for the next week, 2 times for the next week, 1 time for the next week and then stopped).In our study group, the prevalence of steroid-responders was 3.6% with 0.8% showing mild rise, 2.8% showing moderate rise in IOP on the fourth week of topical steroid usage. There was no difference in the mean IOP rise with the usage of two different topical steroids (E/d Prednisolone acetate (1%) and E/d Dexamethasone(0.1%)) in our study. The highest mean IOP was noted at the 5th postoperative day (20.26 mmHg) which was due to inflammation & there was a gradual decrease in IOP in the subsequent weeks of follow-up till 8th week. While as duration after cataract surgery progress till 8th week of follow up, moderate rise in IOP occurs which gradually comes down to mild rise till 8th week of follow-up.Steroid-induced IOP elevation typically occurs after 4 weeks of beginning steroid therapy and the prevalence of steroid responders in post cataract surgery patients was established.