A Study on Steroid Induced Glaucoma among Patients of Keratoconus Following Corneal Collagen Cross Linking

Abstract Purpose: To determine the incidence of steroid induced glaucoma in patients with keratoconus after use of topical steroids following corneal collagen cross linking (CXL). Methodology: 50 patients with progressive keratoconus who underwent Corneal collagen crosslinking were selected and patients were followed up after 1 week, 3 weeks, 6 weeks, 3months and outcome was measured in terms of visual acuity, changes in IOP, CCT, optic nerve head changes. Visual field changes and optic disc. RNFL OCT was done when necessary. Results: The mean age group was 20.89 years. 42% of cases were males. The mean pre-op IOP was 16.5 ± 1.88 mmhg; At 6 weeks 17.72±2.46; At 3 months 16.99± 1.58 mm hg.35 patients (70%) were non responders (IOP rise of less than 5 mmhg from baseline); 13 patients (26%) were intermediate responders (IOP rise of 6-15mm of hg from baseline); 2(4%) patients were high responders(>16 mm of hg rise from baseline).Majority of the spike in IOP happened at 3 weeks. Conclusion The incidence of steroid-induced IOP rise in this cohort was comparable to that of the general population. These findings suggest that while IOP monitoring is essential post-CXL, the risk of persistent steroid-induced ocular hypertension remains low.