The Effect of Corticosteroids on Myopic Regression after Laser in Situ Keratomileusis

ABSTRACT

PURPOSE: This study was to evaluate the effect of topical steroid treatment on eyes that showed myopic regression after LASIK. METHODS: A total of 26 patients (33 eyes) who showed myopic regression more than 1.00 diopter(D) confirmed by topography and pachymeter, were prospectively treated with 1% topical prednisolone acetate. Manifest refraction, Snellen uncorrected visual acuity and intraocular pressure(IOP) were measured before and after treatment. Topical steroids were administered every 2 hours for 3 days and 4 times a day for 11 days. Then the treatments were tapered in the eyes that showed over +0.50 D reversal of myopic regression. But it was immediately stopped in those eyes that showed no improvement or IOP increase. Pachymeter was taken in the improved group 4 weeks after the treatment. RESULTS: Fifteen eyes (45.5 %) showed over +0.50 D reversal of myopic regression(mean +/- SD +1.21 +/- 0.74 D, range +0.50 ~ +2.75) and the uncorrected visual acuity increased (20/45 before treatment, 20/27 after treatment, p<0.01). The mean corneal thickness decreased (501.9 +/- 18.5 micrometer before treatment, 492.2 +/- 19.2 micrometer after treatment, p<0.01). Refractive effect of the steroid treatment remained stable with four of the eight eyes that could be followed up over six months. IOP was elevated in 3 eyes, but readily normalized with pressure-lowering agent. CONCLUSIONS: Topical steroid treatment for myopic regression after LASIK is partially effective and safe. It is recommendable to use topical steroid prior to performing surgical retreatment.