Short-term intraocular pressure elevations after combined phacoemulsification and implantation of two trabecular micro-bypass stents: Prednisolone versus loteprednol

Objective. to compare the effects of prednisolone and of loteprednol after combined phacoemulsification and trabecular micro-bypass stent implantation (phaco-istent). methods. patients who underwent phaco-istent between april 2013 and november 2014 were identified by retrospective chart review. postoperatively,they received either prednisolone (n = 38) or loteprednol (n = 58). baseline data was compared. primary outcomes including intraocular pressure (iop) and number of glaucoma medications (ngm) were analyzed at preoperative visit,postoperative day 1,weeks 1-2,weeks 3-4,and months 2-3. results. both groups had similar preoperative parameters (p > 0.05). the mean iop spike occurred at postoperative weeks 1-2 with an increase of 2.21 ± 7.30 mmhg in the loteprednol group and 2.54 ± 9.28 mmhg in the prednisolone group. it decreased by weeks 3-4 in both groups and continued to improve at months 2-3. ngm showed significant reduction (p < 0.0001) after the surgery and remained stable in both groups. no significant group effect or time-group interaction in iop and ngm evolution was detected (p > 0.05). the proportions of patients needing paracentesis were similar between the two groups. conclusion. similar early iop elevations after combined phaco-istent occurred with both prednisolone and loteprednol. facilitated glucocorticoid infusion,altered aqueous humor outflow,and local inflammation may be contributing factors. © 2015 qianqian wang and paul harasymowycz.