Ophthalmology
Volume 108, Issue 7 , Pages 1236-1244, July 2001

A prospective, randomized comparison of the use versus non-use of topical corticosteroids after laser in situ keratomileusis1

  • Francis W Price Jr., MD

      Affiliations

    • Price Vision Group, Indianapolis, Indiana, USA
    • Corresponding Author InformationReprint requests to Francis W. Price, Jr., MD, 9002 North Meridian Street, Suite 100, Indianapolis, Indiana 46260
    • ,
  • Leslee Willes, MS

      Affiliations

    • Data Coordinating Center Encinitas, California, USA
    • ,
  • Marianne Price, BS, MBA

      Affiliations

    • Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
    • ,
  • Angi Lyng

      Affiliations

    • Cornea Research Foundation of America, Indianapolis, Indiana, USA
    • ,
  • Judy Ries

      Affiliations

    • Cornea Research Foundation of America, Indianapolis, Indiana, USA

Received 25 October 1999; accepted 20 February 2001.

Manuscript no. 99446.

Abstract 

Objective

To evaluate the benefit and safety of topical corticosteroids after laser in situ keratomileusis (LASIK).

Design

Prospective, randomized, double-masked clinical trial.

Participants

A consecutive series of 1747 eyes in 897 patients desiring surgical correction of myopia from plano to −16 diopters (D) with up to 6 D of astigmatism.

Intervention

Patients were randomly assigned to topical corticosteroids or artificial tears.

Main outcome measures

The primary outcome measure was stability of refraction. Secondary outcome measures were differences in best-corrected visual acuity, decrease in spherical refractive myopia, improvement in uncorrected visual acuity, predictability of achieved corrections versus planned corrections, evaluation of postoperative haze, preservation of best-corrected visual acuity, intraocular pressure, and incidence of complications and adverse events.

Results

No difference was found between the groups for refractive accuracy, best-corrected or uncorrected visual acuity, or safety. Topical corticosteroids were associated with a prolonged period of refractive regression in moderate to high myopes (−7.25 to −16.00 D) (P = 0.01). Increased haze was noted at the 1 week examination for eyes not receiving topical steroids (P = 0.008); however, in most cases this was clinically insignificant. Thirty-six eyes (2.1%) required supplemental topical corticosteroids unrelated to reoperation. Two eyes received these on the first postoperative day and 15 at the 1-week examination.

Conclusions

Topical corticosteroids did not seem to play any beneficial role in routine postoperative treatment after LASIK, and they were associated with decreased stability of refraction in more highly myopic eyes. Eyes that require additional topical corticosteroids are easily identified at either the initial postoperative examinations or during the course of routine postoperative care.

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  • 1 The authors have no proprietary or financial interest in any product mentioned in this manuscript.

PII: S0161-6420(01)00624-8

Ophthalmology
Volume 108, Issue 7 , Pages 1236-1244, July 2001

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