THE EFFECT OF TOPICAL CORTICOSTEROIDS ON REFRACTION AND CORNEAL HAZE FOLLOWING EXCIMER-LASER TREATMENT OF MYOPIA - AN UPDATE - A PROSPECTIVE, RANDOMIZED, DOUBLE-MASKED STUDY

Several thousands of myopic patients have undergone photorefractive keratectomy (PRK) worldwide (prior to the publication of long-term, carefully controlled studies). The evidence in support of the currently widespread use of topical corticosteroids after PRK, however, is limited. We report the results of a prospective, double-masked trial to determine the effect of dexamethasone 0.1% on refraction and anterior stromal haze following -3.00 and -6.00 dioptre PRK procedures (n = 113; minimum follow-up 1 year). Initially the reduction in myopia was significantly greater in the steroid group compared with the placebo group (p<0.002). However, on discontinuing the corticosteroids at 3 months this difference became statistically insignificant (p>0.2). There was no statistically significant effect on anterior stromal haze at any stage. We conclude that, in view of their side effects, it would be unacceptable to use topical corticosteroids in the long term to maintain the initial beneficial effect on refraction. We therefore consider that topical corticosteroids should not be used following PRK.