J Korean Ophthalmol Soc.  2014 Dec;55(12):1828-1833. 10.3341/jkos.2014.55.12.1828.

The Effect of Prophylactic IOP-Lowering Medication after Intravitreal Dexamethasone Implantation

• Han JB
• Seo KH
• Yu SY

• KMID: 2338970
• DOI: http://doi.org/10.3341/jkos.2014.55.12.1828

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.

Keyword

Intraocular pressure-lowering medication; Intravitreal dexamethasone implantation; Prophylactic use

MeSH Terms

Dexamethasone*
Humans
Intraocular Pressure
Macular Edema
Optic Nerve
Retina
Retrospective Studies
Dexamethasone

Figure

• 

  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.

• 

  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).

• 

  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).

Reference

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