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Corticosteroids versus NSAIDs on intraocular pressure and the hypertensive phase after ahmed glaucoma valve surgery.
MedLine Citation:
PMID:  20852441     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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±4.7 versus 10.0±4.5 at week 1 (P=0.500); 10.7±6.7 versus 17.5±10.4 at week 2 (P=0.053); 11.0±6.5 versus 18.0±7.3 at week 4 (P=0.013); 14.8±8.6 versus 17.5±5.2 at week 6 to 8 (P=0.323); and 14.8±9.6 versus 17.8±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.
Authors:
Darana Yuen; Yvonne Buys; Ya-Ping Jin; Tariq Alasbali; Michael Smith; Graham E Trope
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of glaucoma     Volume:  20     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-44     Citation Subset:  IM    
Affiliation:
*Department of Ophthalmology and Visual Sciences, Toronto Western Hospital †Dalla Lana School of Public Health, University of Toronto, Toronto, Canada ‡Department of Ophthalmology, King Faisal University, Dammam, Saudi Arabia §Department of Ophthalmology, Royal Devon and Exeter Hospital, Exeter, United Kingdom.
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