The effect of topical corticosteroids on refractive outcome and corneal haze after photorefractive keratectomy. A prospective, randomized, double-blind trial
D. S. Gartry, M. G. Muir, C. P. Lohmann and J. Marshall
Department of Ophthalmology, St Thomas' Hospital, London, England.
In this study, we report the results of a prospective, double-blind trial
to determine whether high-dose topical corticosteroids have an effect on
refractive outcome or anterior stromal haze after photorefractive
keratectomy. A total of 113 patients were allocated randomly to either
placebo- or steroid-treated groups (0.1% dexamethasone metasulphobenzoate
for 3 months) and underwent either -3.00-diopter (D) or -6.00-D procedures.
At 6 weeks, the mean change in refraction was significantly greater in the
steroid-treated group than in the placebo-treated group (-3.00-D group, P =
.0015; -6.00-D group, P = .0011). However, when corticosteroids were
discontinued at 3 months, this difference became statistically
insignificant. There was no statistically significant effect on anterior
stromal haze at any stage. Since long-term use of corticosteroids to
maintain the initial beneficial effect on refraction would be unacceptable,
we conclude that these agents should not be used after photorefractive
keratectomy.
