Journal List > J Korean Ophthalmol Soc > v.55(12) > 1009866

Han, Seo, and Yu: The Effect of Prophylactic IOP-Lowering Medication after Intravitreal Dexamethasone Implantation

Abstract

Purpose

To investigate the effect of prophylactic intraocular pressure (IOP)-lowering medication after intravitreal dexamethasone implantation.

Methods

This is a retrospective analysis of 39 eyes undergoing intravitreal dexamethasone implantation for macular edema. Eyes were divided into two groups, those which had used prophylactic IOP-lowering medication and those which had not. IOP was measured preoperatively, at one week, and monthly until six months post-injection in each group.

Results

The mean pre-injection IOP for the group that had not used prophylactic IOP-lowering medication and the group that had was 13.95 ± 3.32 mm Hg and 13.56 ± 3.71 mm Hg, the mean post-injection IOP at two months was 15.81 ± 3.75 mm Hg and 12.56 ± 5.02 mm Hg, and that at six months was 12.90 ± 2.95 mm Hg and 11.44 ± 3.59 mm Hg, respectively. The difference between the two groups was statistically significant at one week, one month, two months, and three months (p = 0.001, 0.002, 0.011, 0.035, respectively). A greater than 22 mm Hg increase in IOP was seen in four eyes (19.05%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had. A greater than 5 mm Hg increase in IOP from baseline was seen in eight eyes (38.10%) in the group that had not used IOP-lowering medication and in one eye (5.56%) in the group that had.

Conclusions

After intravitreal dexamethasone implantation, prophylactic IOP-lowering medication will significantly prevent IOP increase and decrease the number of patients requiring additional treatment that could cause potential damage to the retina and optic nerve.

References

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Figure 1.
Graph showing the mean intraocular pressure (IOP) after intravitreal dexamethasone implantation in patients who are on prophylactic anti-glaucomatic drug (use) and in patients who are not on prophylactic anti-glaucomatic drug (not use). *p < 0.05.
jkos-55-1828f1.tif
Figure 2.
Cumulative response rate of cases with incident intraocular pressure (IOP) rise more than 22 mm Hg by months since initial intravitreal dexamethasone implantation in patients who are on prophylactic anti-glaucomatic drug (use) and in patients who are not on prophylactic anti-glaucomatic drug (not use) (p = 0.209, log rank test).
jkos-55-1828f2.tif
Figure 3.
Cumulative response rate of cases with incident intraocular pressure (IOP) rise more than 5 mm Hg from baseline by months since initial intravitreal dexamethasone implantation in patients who are on prophylactic anti-glaucomatic drug (use) and in patients who are not on prophylactic anti-glaucomatic drug (not use) (p = 0.016, log rank test).
jkos-55-1828f3.tif
Table 1.
Patients demographics in each group
Variable Not use (n = 21) Use (n = 18) p-value
Age (years) 62.24 ± 11.90 63.50 ± 12.01 0.835*
Sex (M:F) 8:13 5:13 0.496
Disease (RVO:DR:AMD) 9:9:3 9:6:3 0.599
Baseline IOP (mm Hg) 13.95 ± 3.32 13.56 ± 3.71 0.530*

Values are presented as mean ± SD unless otherwise indicated.

RVO = retinal vein occlusion; DR = diabetic retinopathy; AMD = age-related macular degeneration; IOP = intraocular pressure.

* Mann-Whitney test;

Chi-square test;

Linear by linear association.

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