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Intracanalicular Dexamethasone Insert or Topical Prednisolone following iStent and Hydrus Surgery for Glaucoma

J Glaucoma. 2022 Apr 14. doi: 10.1097/IJG.0000000000002037. Online ahead of print.

ABSTRACT

PRCIS: Using an intracanalicular dexamethasone insert or topical prednisolone following iStent and Hydrus surgery provided similar short-term control of post-operative inflammation.

PURPOSE: To compare post-operative inflammation in patients who received an intracanalicular dexamethasone insert or topical prednisolone after iStent or Hydrus surgery.

PATIENTS AND METHODS: Patients receiving a dexamethasone insert after iStent or Hydrus insertion were included and compared to age-matched controls who received topical prednisolone. Pre-operative data were recorded. Post-operative inflammatory cell and the proportion of patients with zero anterior chamber cells was recorded at month 1. Post-operative IOP and rate of cystoid macular edema (CME) were recorded at months 1 and 3.

RESULTS: 40 eyes receiving topical prednisolone were compared to 35 eyes receiving a dexamethasone insert after iStent or Hydrus insertion. Mean post-operative inflammatory cell for the topical group at month 1 was 0.2±0.3, and the dexamethasone group, 0.3±0.5;P=0.816. 70% of patients in the topical group had zero anterior chamber cell at post-operative month 1 compared to 75.8% in the dexamethasone group,P=0.583. Mean pre-operative IOP for the topical group was 18.8±5.5 and the dexamethasone group was 17.1±4.1,P=0.064. Mean post-operative IOP for the topical group at months 1 and 3 was 17.6±6.4 and 15.1±3.1, respectively and the dexamethasone group, 17.5±4.8 and 15.0±3.4, respectively;P=0.772 and 0.884. One patient developed CME in each group.

CONCLUSIONS: There was no statistically significant difference in the proportion of patients who had zero anterior chamber cell at post-operative month 1 between groups.

PMID:35439795 | DOI:10.1097/IJG.0000000000002037

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