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Abstract #27424 Published in IGR 12-4
Corticosteroids versus NSAIDs on intraocular pressure and the hypertensive phase after ahmed glaucoma valve surgery
Yuen D; Buys Y; Jin Y-P; Alasbali T; Smith M; Trope GEJournal of Glaucoma 2010;
PURPOSE: To compare the effect of topical steroids versus nonsteroidal anti-inflammatory drugs on intraocular pressure (IOP) and the hypertensive phase (HP) after Ahmed glaucoma valve surgery. PATIENTS AND METHODS: Prospective, randomized, double-masked controlled trial. Twenty-eight consecutive consenting patients scheduled for Ahmed glaucoma valve surgery were randomized to receive either postoperative topical dexamethasone or ketorolac. The main outcome measure was IOP. Secondary outcomes included incidence of HP, visual acuity, number of glaucoma medications, postoperative complications, and subsequent procedures. RESULTS: The mean postoperative IOP (in mm Hg) in the ketorolac versus dexamethasone arms respectively was as follows: 8.8(plus or minus)4.7 versus 10.0(plus or minus)4.5 at week 1 (P=0.500); 10.7(plus or minus)6.7 versus 17.5(plus or minus)10.4 at week 2 (P=0.053); 11.0(plus or minus)6.5 versus 18.0(plus or minus)7.3 at week 4 (P=0.013); 14.8(plus or minus)8.6 versus 17.5(plus or minus)5.2 at week 6 to 8 (P=0.323); and 14.8(plus or minus)9.6 versus 17.8(plus or minus)7.5 at week 10 to 12 (P=0.374). Four patients (31%) in the ketorolac arm versus 8 patients (53%) in the dexamethasone arm exhibited the HP (P=0.276). Wound leak was the most severe complication and there were 3 cases (23%) in the ketorolac group versus nil in the steroid group (P=0.087). Conjunctival retraction was observed in 8 patients (62%) in the ketorolac arm versus 2 patients (13%) in the dexamethasone arm (P=0.016). CONCLUSIONS: Mean IOP was greater at all time points postoperatively in the steroid group with the difference between groups statistically significant at week 4. The nonsteroidal anti-inflammatory drug group showed greater wound-healing problems.
D. Yuen.
Classification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
