Purpose: We conducted a prospective observational study to compare the effects of ophthalmic steroids (topical steroids) on intraocular pressure (IOP) after strabismus surgery in children and ≥16 years old.
Patients and methods: We included 24 children aged<16 years (mean age, 9.3±3.3 years) and 22 aged ≥16 group (mean age, 45.4±20.1 years) who underwent strabismus surgery at our department between January and December 2020. The pediatric group was further classified according to age as <9 years (13 eyes in 13 children; mean age, 6.8±1.0 years) and ≥9 years (11 eyes in 11 children; mean age, 12.3±2.3 years). All participants received four daily ophthalmic administrations of 0.1% betamethasone sodium phosphate from the day after surgery to the seventh day after surgery; further, they received 0.1% fluorometholone from the eighth day after surgery to 1 month after surgery. IOP was measured using the iCare-Pro Rebound Tonometer (M. E. Technica, Corp.) at baseline as well as 1 week and 1 month after surgery.
Results: IOP (mmHg)at baseline, 1 week, and 1 month after surgery was 15.7±2.4, 20.7±5.4, and 16.6±3.4 in children aged <9 years; 16.7±2.2, 16.9±3.7, and 17.2±3.4 in those aged ≥9 years; and 15.1±3.3, 15.7±2.1, and 14.2±2.2 in aged ≥16 group, respectively. Thus, IOP was significantly higher in children aged <9 years at 1 week after surgery (p< 0.01, Friedman test, Shaffer post hoc test). An increase in IOP of 6-15 mmHg at 1 week after surgery was observed in four children aged <9 years and one aged ≥16 group, whereas an increase in IOP of ≥16 mmHg was observed in one child aged <9 years.
Conclusions: The administration of ophthalmic steroids after strabismus surgery may induce ocular hypertension in children, particularly in those aged <9 years. Therefore, ophthalmic steroids must be carefully administered with IOP monitoring. The iCare-Pro Rebound Tonometer is a simple and effective device for measuring IOP in children.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 1039-1045, 2022.