Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.
Department of Glaucoma, Medical Research Foundation, Sankara Nethralaya, Chennai, India.
Retina. 2019 Jan;39(1):157-162. doi: 10.1097/IAE.0000000000001924.
To assess the changes in intraocular pressure (IOP) after dexamethasone (DEX) implant in patients with glaucoma or history of steroid responders.
A retrospective study of patients who received DEX implant was conducted in a tertiary care center in India. Demographic details and IOP measurements at preinjection and postinjection were collected. The proportion of patients with and without IOP rise after DEX implant was noted, and the number of antiglaucoma medications to control the IOP was analyzed. The changes in IOP were also compared in the group with no glaucoma/steroid responder.
A total of 815 patients, 767 patients in the nonglaucoma group and 48 patients in the glaucoma referral group, who underwent DEX implant were included in this study. The overall mean (SD) age of study participants was 56.3 (SD = 12.6) years. The overall mean (SD) IOP at baseline and at follow-up after injection for both nonglaucoma and glaucoma referral groups was found to be significant (P < 0.001). The differences in IOP measurements across follow-ups after DEX implant were found to be significant in both nonglaucoma (P < 0.001) and glaucoma referral groups (P < 0.001). Among the study patients in the IOP-rise group, 46.43% had maximum IOP rise in 1-week follow-up and 39% in 2-week follow-up, where 78.6% showed IOP controlled with 1 antiglaucoma medication.
The rise in IOP after DEX implant was noted within first 2 weeks, which can be managed with topical antiglaucoma medications. Hence, with a close early follow-up monitoring of IOP, and timely medical intervention, DEX implant can be performed in patients with glaucoma.
评估接受地塞米松（DEX）植入的青光眼或类固醇反应者患者的眼压（IOP）变化。
在印度的一家三级护理中心进行了一项回顾性研究，该研究纳入了接受 DEX 植入的患者。收集了患者的人口统计学细节和注射前及注射后的 IOP 测量值。记录了 DEX 植入后眼压升高的患者比例，并分析了控制眼压所需的抗青光眼药物数量。还比较了无青光眼/类固醇反应者组的 IOP 变化。
本研究共纳入 815 名患者，其中 767 名非青光眼组患者和 48 名青光眼转诊组患者接受了 DEX 植入。研究参与者的总体平均（SD）年龄为 56.3（SD=12.6）岁。非青光眼和青光眼转诊组的基线和注射后随访的总体平均（SD）IOP 均显著升高（P<0.001）。DEX 植入后随访期间的 IOP 测量值差异在非青光眼组（P<0.001）和青光眼转诊组（P<0.001）中均具有统计学意义。在眼压升高组的研究患者中，46.43%的患者在 1 周随访时眼压升高最高，39%的患者在 2 周随访时眼压升高最高，其中 78.6%的患者眼压升高用 1 种抗青光眼药物控制。
DEX 植入后 IOP 升高发生在最初的 2 周内，可以通过局部抗青光眼药物来控制。因此，通过早期密切的眼压监测和及时的医疗干预，DEX 植入可以在青光眼患者中进行。
