title: Higher incidence of steroid-induced ocular hypertension in keratoconus.
abstract: BACKGROUND
  To compare intraocular pressure (IOP) changes following topical dexamethasone administration for 1 month in keratoconic versus normal eyes.
  
  
  METHODS
  This is a retrospective, single-center, non-randomized case series evaluation of 350 eyes. Two groups were formed: normal/control Group A (nA =73), eyes that underwent excimer laser photorefractive keratectomy; and keratoconic (KCN) Group B (nB =277), eyes that were subjected to partial laser photorefractive keratectomy combined with collagen cross-linking (The Athens Protocol). All eyes received the same post-operative regimen of topical dexamethasone 0.1 % for at least 1 month. Goldmann applanation tonometry IOP readings and central corneal thickness (CCT) measurements were monitored. Cases with induced ocular hypertension (OHT, defined as post-operative IOP higher than 21 mmHg), were identified and correlated to refractive procedure, gender, and corneal thickness.
  
  
  RESULTS
  At 4 weeks postoperatively, OHT was noted on 27.4 % (20 /73 eyes) in Group A, and 43.7 % (121 /277 eyes) in KCN Group B, (p <0.01). Six months post-operatively (following 5-months of discontinuing topical dexamethasone treatment and commencing treatment of IOP-lowering medications), OHT rate was 1.8 % in Group A and 3.9 % in the KCN Group B.
  
  
  CONCLUSIONS
  This study demonstrates a potentially significant pre-disposition of keratoconic eyes to the development of steroid-induced OHT.
authors.affiliation: Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece ; NYU Medical School, New York, NY USA.
authors.forename: Anastasios John
authors.initials: AJ
authors.lastname: Kanellopoulos
authors.affiliation: Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece ; Asian Eye Institute, Makati, Philippines.
authors.forename: Emerson M
authors.initials: EM
authors.lastname: Cruz
authors.affiliation: Asian Eye Institute, Makati, Philippines.
authors.forename: Robert Edward T
authors.initials: RE
authors.lastname: Ang
authors.affiliation: Laservision.gr Clinical and Research Eye Institute, 17 Tsocha Street, Athens, Postal Code: 11521 Greece.
authors.forename: George
authors.initials: G
authors.lastname: Asimellis
keywords: CXL; Corneal collagen cross-linking; Corticosteroid induced ocular hypertension; Dexamethasone topical ophthalmic solution; IOP spike; Intraocular pressure; Keratoconus; Photorefractive keratectomy; The Athens protocol; Topography-guided