Ocular hypertensive response to topical dexamethasone ointment in children.
OBJECTIVE
To investigate the rate and the degree of the ocular hypertensive response to dexamethasone ointment in children undergoing eyelid surgery.


METHODS
Dexamethasone ointment (Dexcosil) was applied three times a day for the first week and twice a day for the second to third week postoperatively to children undergoing epiblepharon surgery. Intraocular pressure (lOP) was measured on the day before surgery, postoperative day 1, 7, 14, 21, 28 and 2 weeks thereafter until the IOP reached preoperative levels. Peak IOP, IOP net increase and time to reach a peak IOP were analyzed. Dexamethasone ointment was discontinued if the IOP was 25 mmHg or more.


RESULTS
A total of 96 children (mean age, 6.5 +/- 2.7 years) were included. Preoperative mean IOP was 13.6 +/- 2.9 mmHg (range 7-19). After dexamethasone ointment treatment, the children showed a significant rise in IOP as compared with the preoperative values. The peak IOP was 20.6 +/- 4.9 mmHg (range 11-39) and the time to reach peak IOP was 8.5 +/- 5.9 days. The low responders (delta IOP < or = 5 mmHg) of our group comprised 35.4% (34/96) of patients, intermediate responders (delta IOP 6-15 mmHg) comprised 56.3% (54/96) of patients and high responders (delta IOP > or =16) comprised 8.3% (8/96) of patients. A net increase in IOP was significantly higher in children 5 years old or less as compared with those older than 5 years (age < or =5, 9.4 +/- 7.5 mmHg vs. age > 5, 6.3 +/- 4.4 mmHg; p = 0.015, unpaired t-test).


CONCLUSIONS
Ocular hypertensive response after dexamethasone ointment to the eyelids occurred frequently in children, especially those 5 years old or younger.
Lee
Yoon Jung
YJ
Department of Ophthalmology, Hanyang University, School of Medicine, Hanyang University Kuri Hospital, Gyeonggi, Korea
Park
Chan Yi
CY
Woo
Kyung In
KI
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D005141:Eyelid Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D009824:Ointments; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies
D005938:Glucocorticoids; D009824:Ointments; D003907:Dexamethasone