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Six month results of using 0.05% cyclosporinum after surface ablation in cases of steroid-induced ocular hypertension

Poster Details

First Author: E.Eskina RUSSIA

Co Author(s):    V. Parshina   P. Rybakoff           

Abstract Details



Purpose:

To evaluate the postoperative outcomes, effectiveness and safety using 0,05% Cyclosporinum among high myopic patients who had underwent PRK treatment and developed steroid hypertension during the observation period.

Setting:

Laser surgery clinic SPHERE, Moscow, Russia

Methods:

14 patients (28 eyes) in mean age 25,9±6 y.o. - the Main group and 27 patients (54 eyes) in mean age 27±6,4 y.o. - the Control group, with Myopia -5,41±1,8 D in SEQ and -5,14±2,6 D and 16,98±3,68 mmHg and 15,16±2,52 mmHg corneal compensated IOP (CC IOP) respectively, underwent the surface ablation, using the TransPRK approach. After the epithelisation, patients in both groups were prescribed by standard steroid (0,1% Sol. Dexamethason) treatment to stabilize the refractive effect after the operation. In 9,8% of cases after 3-4 weeks of steroid treatment the IOP has been increased and using of standard anti-glaucomatous eye-drops were not efficient enough. To preserve the refractive effect and to avoid the Optical nerve damage the steroid treatment was cancelled and the 0,05% Cyclosporinum twice per day for eight weeks was prescribed. TransPRK treatments were planned with Custom Ablation Manager software and ablations performed using the SCHWIND AMARIS laser system (both SCHWIND eye-tech-solutions). TransPRK with Mitomycin C has been carried out in all cases. Standard examinations, including UVA and BCVA testing, noncontact tonometry were performed. Clinical outcomes of six months follow-up were analysed.

Results:

At 1 month after the operation visit, the CC IOP in Main group increased up to 29,18±7,29 mmHg in spite of using 0,5% of Betaxololum twice per day, in the Control group CC IOP was 12,77±2,8 mmHg without any additional treatment (p<0,01). UVA in the Main group was 0,88±0,17, in the Control group 0,92±0,11 (p>0,05). BCVA was 0,95±0,12 and 0,96±0,08 respectively. The SEQ -0,11±0,29 D and -0,08±0,2 D. Steroid treatment in Main group was cancelled and the 0,05% Cyclosporinum twice per day for eight weeks was prescribed. At 6 month after the operation period UVA in the Main group was 0,98±0,05, in the Control group 0,96±0,09, BCVA 1,03±0,06 and 0,97±0,14 respectively (p>0,05). The CC IOP was 16,2±3,21 and 17,31±1,92 (p>0,05) without any additional treatment, the SEQ -0,04±0,12 D and -0,04±0,2 D respectively.

Conclusions:

In cases of uncontrolled steroid induced increasing of IOP after surface ablations, usage of 0,05% Cyclosporinum shows us safe results and predictable refractive outcome. No significant side effects had been found out. Further investigations and long-time observations should be performed to estimate the effectiveness and safety of using 0,05% Cyclosporinum in surface ablations postoperatively. FINANCIAL INTEREST: NONE

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