THE EFFECT OF DEEP POSTERIOR SUBTENON INJECTION OF CORTICOSTEROIDS ONINTRAOCULAR-PRESSURE

PURPOSE: To investigate the effect of posterior subtenon injections of corticosteroids on intraocular pressure in a variety of ocular diseas es. METHODS: We retrospectively analyzed 202 consecutive posterior sub tenon corticosteroid in jections (148 of methylprednisolone acetate, 8 0 mg, and 54 of triamcinolone acetonide, 40 mg) in 63 eyes of 55 patie nts (26 male, 29 female; mean age +/- SD, 60.17 +/- 26.55 years). All patients had received topical or systemic corticosteroids before the i njection, and no rise in intraocular pressure had been noted. Preinjec tion and postinjection intraocular pressure measurements were compared by two tailed paired t test. Statistical analysis was performed separ ately by patient (first injection of first injected eye), by eye (firs t injection of each eye), and by all injections. To detect increase in intraocular pressure during follow up, statistical analysis was perfo rmed separately 14 to 90 days, 91 to 150 days, and 151 to 270 days aft er injection. RESULTS: No statistically significant difference was fou nd between preinjection and postinjection intraocular pressure measure ments. A power calculation in the most stringent subanalysis (by patie nt) proved that there is only a 3.87% chance to statistically miss a c linically significant rise in intraocular pressure from 15 to 21 mm Hg . CONCLUSIONS: Posterior subtenon injection of corticosteroids does no t cause an increase in intra ocular pressure. All patients in our stud y had been treated previously with topical or systemic cortico steroid s and did not react with an excessive in crease in intraocular pressur e. This safety of repository corticosteroids may therefore not. apply to patients whose status in responding to cortico steroids is not know n.