ABSTRACT
Purpose: to evaluate the role of prophylactic topical steroids in the prevention of DLK after LASIK
Methods: in a randomized double blind clinical trial, 101 LASIK candidates aged 18 to 55 years were enrolled. Myopia ranged from -2 to -12 diopters and was stable for at least one year. No patient had any ocular or systemic contraindication for LASIK. From one day before surgery, topical betamethasone 0.1% was randomly applied for one eye every 4 hours while the other eye received placebo. One hour before surgery the dosage was increased to every 5 minutes for at least six times. All operations were performed by one surgeon [F.K]. Both eyes were operated in one setting. Six hours after surgery, all the eyes were put on topical betamethasone every 2 hours and dosage was tapered depending on the response and according to the grade of DLK if present. Severity of DLK was graded according to the Linebarger-Lindstorm classification. Patients were regularly examined in the first week and if the postoperative course was uneventful they were re-examined one and three months after surgery. Vision [BCVA], refraction [cyclorefraction], and severity of DLK were documented by a third examiner at each visit
Results: one hundred eyes were in the treatment and 98 eyes were in the control group. In both groups, pre and post LASIK refraction and VA were comparable [P> 0.05]. There were no significant complications in both groups during or after LASIK except for DLK. DLK was seen in 55 eyes [55%] of the treatment group including 44 eyes [44%] with grade I and 11 eyes [11%] with grade II. In the control group DLK was seen in 36 eyes [36.7%] of which 29 eyes [29.5%] were grade I, and 7 eyes [7.2%] were grade II. There was no statistically significant difference between the incidence of DLK in the two groups [P= 0.81]. More severe grades of DLK [III and IV] were not seen in any group
Conclusion: although steroids [topical and systemic] play a key role in the treatment of DLK, they seem to have no inhibitory role on DLK