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Nisha R. Acharya, MD, MS; Muthiah Srinivasan, MD; Jeena Mascarenhas, MD; Meenakshi Ravindran, MD; Revathi Rajaraman, MD; Michael Zegans, MD; Stephen McLeod, MD; Thomas M. Lietman, MD

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The January 2009 Controversies series of articles highlights a major debate.^1-2 Some corneal specialists use adjunctive corticosteroids to reduce scarring in bacterial keratitis. Others fear that suppressing the immune system is the worst thing you can do. Hindman and Patel et al¹ state that only a single, underpowered trial has addressed this and suggest that a large definitive trial is necessary to end the debate. By the time this Controversies series was published, there had actually been 2 published trials,^3-4 and a third, large trial is well under way.

We recently published the results of a randomized trial of 42 patients that studied the effect of adjunctive topical steroids in bacterial keratitis.⁴ Although steroids affected neither acuity nor scar size, they did significantly . . . [Full Text of this Article]

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