Ocular Hypertension after Myopic Photorefractive Keratectomy

To evaluate the incidence of steroid-induced ocular hypertension (OHT) after myopic photo-refractive keratectomy (PRK). Myopic PRK was performed on 506 eyes of 269 patients. Refractive error was between -1.00 and -5.00 diopters of sphere and less than 4 diopters of cylinder. Baseline intraocular pressure (IOP) before the operation and at different time intervals after the operation was measured using Goldman Applanation Tonometry. Corrected IOP more than 21 mmHg was considered as OHT. OHT occurred in 40 (7.9%) eyes. IOP rise occurred after 2-3 weeks in 40% (mean IOP= 23.5±3 mmHg), 4-6 weeks in 50% (mean IOP= 25.06±4.2 mmHg) and 8-12 weeks in 10% (mean IOP= 28.98±3.12 mmHg). There was no correlation between IOP and preoperative spherical equivalent. IOP recovered to normal in all patients after discontinuation of topical steroid and using 0.5% timolol. Mean duration for normalization of IOP was 28.5±27.7 (range 7-108) days. There was no case of steroid-induced glaucoma. Topical steroids may cause OHT in patients undergoing PRK. Early detection of IOP rise and meticulous treatment with close follow-up are recommended. We suggest measuring IOP in post-PRK patients at least after 2 to 3 weeks of corticosteroid treatment initiation.