Risk factors for early onset elevated intraocular pressure after pterygium surgery

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 12; pp. 1539 - 1547
• Main Authors: Wu, Kevin, Lee, Hyunjoo J, Desai, Manishi A
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Cataracts; Comparative analysis; Eye surgery; Glaucoma; Hypertension; Medical centers; Medical research; Neomycin; ocular hypertension; Ophthalmology; Original Research; Patients; post-operative care; Postoperative care; Postoperative period; Race; Regression analysis; Risk factors; Statistical analysis; steroid; Studies; United States > US; postoperative care; ocular hypertension; intraocular pressure; race; steroid
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S159592

In this study, we aimed to identify the risk factors for early postoperative elevation of intraocular pressure (IOP) after pterygium surgery.
All patients in this retrospective cohort study were evaluated for inclusion from a single tertiary care center at Boston Medical Center. Their pre- and postoperative IOP measurements (day 1, week 1, month 1, month 3, and when clinically necessary) were compared. Patients with postoperative IOP measurement of >22 mmHg or with an increase in IOP by ≥10 mmHg compared with the preoperative measurement value were grouped as "Ocular Hypertension" group; otherwise, patients were grouped in the "No Ocular Hypertension" group. Age, sex, race, baseline IOP, cup-to-disc (C/D) ratio, history of glaucoma, and frequency of use of postoperative steroid drops in all patients were compared. Chi square test was performed to compare the categorical variables, whereas Student's
-test was performed to compare continuous variables. We performed a multivariate logistic regression analysis of categorical data with a significance level of
< 0.05.
In total, 240 patient charts were reviewed for inclusion in this study. Twenty-six patients required pterygium surgery on both eyes; for these patients, the eye with higher IOP was analyzed. Two patients were discontinued from this study because of elevated IOP in the contralateral, nonsurgical eye. Fortyeight out of 212 eyes (22.64%) developed postsurgical elevation of IOP within the first 3 months of operation. No significant differences were found between age, sex, baseline IOP, C/D ratio, history of glaucoma diagnoses, and frequency of use of postoperative steroid drops. However, Hispanic/Latino race (
= 0.036) and lack of application of steroid ointment (
= 0.001) were found to be the significant risk factors for the development of "Ocular Hypertension" in multivariate analysis.
Early elevation of IOP is a risk of pterygium surgery. One nonmodifiable risk factor, Hispanic/Latino race, and one modifiable risk factor, lack of application of steroid ointments, were identified as potential causes of early postoperative IOP elevation.