Abstract
Of 16 patients with Fuchs’ corneal dystrophy who were classified prospectively and in masked fashion by an in vitro assay of corticosteroid responsiveness (using their lymphocytes), only 2 (13%) were found to be markedly responsive. Both developed clinically significant elevations of intraocular pressure in the eyes subjected to topical corticosteroids postkeratoplasty and required anti-glaucomatous therapy for more than three months postoperatively. Of the 10 other patients undergoing keratoplasty, one developed a clinically significant pressure elevation in one eye but not in his fellow eye.
Since peripheral anterior synechias were present in the affected eye and not in the contralateral eye that received the same postoperative corticosteroid therapy, cortico-steroid-induced pressure elevation seemed unlikely in this patient.
These preliminary results suggested that in vitro corticosteroid testing prior to keratoplasty might be helpful in identifying those patients who will develope cortico-steroid-induced intraocular pressure elevation.