title: Risk factors for steroid response among cataract patients.
abstract: OBJECTIVE
  To evaluate the age and ocular axial length (AL) of topical steroid responders after uneventful cataract surgery.
  
  
  METHODS
  Private practice, Los Altos, California, USA.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  This retrospective chart review comprised consecutive patients from a single-surgeon practice who had cataract surgery during a 2-year period. All patients routinely received topical prednisolone acetate 1.0% postoperatively. In addition to AL and patient age, the intraocular pressure (IOP) was recorded preoperatively, 1 day postoperatively, and at least 1 additional time in the first postoperative month while the patient was taking a topical corticosteroid agent. A steroid response was defined as an IOP increase greater than 25% while on topical prednisolone (minimum 28 mm Hg) followed by a decrease of more than 25% after topical prednisolone was discontinued. The age and AL were compared between steroid responders with nonresponders.
  
  
  RESULTS
  Of the 1642 patients, 39 were diagnosed as steroid responders. Younger age and a longer AL were associated with a higher risk for steroid response, particularly in patients younger than 65 years with an AL of at least 29.0 mm. These patients had a 39-fold increased risk for an IOP higher than 28 mm Hg and a 35-fold increased risk for an IOP higher than 35 mm Hg than patients older than 65 years with a normal AL.
  
  
  CONCLUSIONS
  Younger patients with high myopia had a higher risk for a postoperative steroid response after uneventful cataract surgery and may require more frequent IOP monitoring or alternative topical antiinflammatory medications.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: dceye@earthlink.net
authors.forename: David F
authors.initials: DF
authors.lastname: Chang
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tan
authors.forename: Yorghos
authors.initials: Y
authors.lastname: Tripodis
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058452:Axial Length, Eye; D016022:Case-Control Studies; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000175:diagnosis; D018918:Phacoemulsification; D011239:Prednisolone / Q000009:adverse effects / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone