Relationship Between Steroid Induced Intraocular Pressure and Central Corneal Thickness Pre and Post Compound Myopic Astigmatism Photorefractive Keratectomy: Prospective Study رسالة ماجستير

Abstract

Introduction: Photorefractive keratectomy (PRK) is a widely used laser refractive surgery for correcting refractive errors. PRK patients are advised to use steroid drops to minimize corneal haze and inflammation, but their use may decrease aqueous humor outflow and potentially increase the intraocular pressure (IOP) in some patients. Central corneal thickness (CCT) has traditionally been considered a potential predictor of postoperative IOP fluctuations. Objectives: This study aimed to investigate whether preoperative CCT is associated with postoperative steroid-induced IOP elevation post PRK in patients with compound myopic astigmatism and to evaluate the clinical relevance of CCT as a predictor of postoperative steroid response. Methods: A prospective observational study was conducted involving 100 eyes of 50 patients aged 18–35 years undergoing PRK at the Russian Eye Centre in Hebron, Palestine. Preoperative tests included comprehensive eye examinations, IOP measurement using air puff tonometry and CCT measurement using the Pentacam. Postoperative care involved Moxifloxacin 5 mg/mL eye drops and Prednisolone Acetate 1% eye drops. Follow-ups at 10 days, one week and one month included measurements of IOP and CCT. Statistical analysis examined the relationship between preoperative CCT and changes in post-IOP. Results: Postoperative data analysis showed a significant decrease in CCT (p < 0.001), but no significant change in IOP (p > 0.05). Differences in CCT pre- and post-operative were not significantly associated with postoperative IOP changes. Additionally, grouping patients by IOP elevation (≤2 mmHg vs. >2 mmHg) showed no notable differences in age or baseline CCT. Conclusion: CCT cannot predict the degree of IOP rise. An evaluation after surgery should consider more than just CCT: biomechanical parameters need to be included also. The risk of a rise in postoperative IOP might be reduced by using weaker steroids. Future research should use larger numbers of study participants and have more extended follow-up periods to give a complete biomechanical evaluation of the outcome of surgery.