Title: A Clinical Study on Changes in Iop after Dexamethasone Usage Following Manual Small Incision Cataract Surgery
Authors: Dr Divya Prasad, Dr Lokesh H M
DOI: https://dx.doi.org/10.18535/jmscr/v9i1.38
Abstract
Introduction: Cataract is any opacification in lens or its capsule. On the basis of cost effectiveness and feasibility for almost all types of cataract, manual small incision cataract surgery (MSICS) is popular. A dreaded complication as post operative endophthalmitis prompts the need for post operative antibiotics and steroids to control infection and prevent inflammation. But steroid induced glaucoma, corticosteroid induced ocular hypertension are the known leading drawbacks of steroid usage. This study aims at detecting the rise in IOP after the usage of Dexamethasone following MSICS.
Study Design: This is a prospective observational study conducted from November 2018 to April 2020. Total of 59 consecutive non glaucomatous senile and presenile, mature and immature cataract were operated by MSICS and started on Dexamethasone eye drops postoperatively for 6 weeks. Evaluation of changes in IOP preoperatively in comparison to the IOP 6 weeks postoperatively, was recorded by Goldmann Applanation Tonometry.
Results: The mean preoperative IOP among the study subjects was 17.05 mmhg, which increased to a mean IOP of 19.32mmhg after 6 weeks of dexamethasone usage following small incision cataract surgery.
Conclusion: Dexamethasone is a safe and potent corticosteroid which effectively reduces the post operative inflammation and pain. Dexamethasone is a safe drug which carries very low risk of IOP rise if the schedule is followed. The patient compliance with respect to the frequency of instillation of Dexamethasone is most important to obtain good outcome.
Keywords: Manual small incision cataract surgery, Intraocular Pressure, Dexamethasone.
References
- Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012 May;96(5):614-8. doi: 10.1136/bjophthalmol-2011-300539. Epub 2011 Dec 1. PMID: 22133988.
- Blumenthal M. Manual ECCE, the present state of the art. Klin Monatsbl Augenheilkd 1994; 205(5): 266-270.
- Blumenthal M, Glovinsky Y. Surgical consequences in coexisting cataract and glaucoma. Current Opinion Ophthalmology 1995; 6(2): 15-18.
- Sharma PD, Madhavi MR. A comparative study of postoperative intraocular pressure changes in small incision vs conventional extracapsular cataract surgery. Eye 2010 Apr;24(4):608-12.
- Gogate PM, Deshpande M, Wormald RP, Deshpande R, Kulkarni SR. Extracapsular cataract surgery compared with manual small incision cataract surgery in community eye care setting in western India: a randomised controlled trial. Br J Ophthalmol. 2003:87(6):667–72.
- Sahasrabudhe Vivek, M, Kamble Nikhil, R. Study of effect of topical 005% Difluprednate on Intra Ocular Pressure in patients operated by Small Incision Cataract Surgery. Saudi J Med Pharm Sci. 2016;2(3): 56-58.
- Yassin SA, Al-Tamimi ER. Age, gender and refractive error association with intraocular pressure in healthy Saudi participants: A cross-sectional study. Saudi J Ophthalmol. 2016 Jan-Mar;30(1):44-8. doi: 10.1016/j.sjopt.2015.11.007. Epub 2015 Nov 23. PMID: 26949358; PMCID: PMC4759511.