The Necessity of Topical Corticosteroid After Excimer Laser Photorefractive Keratectomy

ABSTRACT

The effect of topical steroid application on clinical results of 215 eyes(126 patients) performed with excimer laser photorefractive keratectomy (PRK) from July 1993 to July 1994 was evaluated, postopertively. The range of myopia was between -2.5 and -11.5 diopter and followed for 9 months after PRK with Summit Omnimed(TM). Topical corticosteroid or non-steroidal antiinflammatory drug (NSAID) was not applied for one month after operation in all cases. After one month, in cases of 115 eyes showing myopic regression of more than -1 diopter or stromal haziness of more than grade 1(delayed steroid group; DSG), 0.1% fluorometholone was applied 4 times daily for 4 weeks, then tapered according to the planned schedule. 46.5% (100 eyes, non-steroid group;NSG) did not show the myopic regression nor stromal haziness without treatment of fluorometholone throughout the follow-up period. Uncorrected visual acuity, spherical equivalent and corneal haziness were evaluated 1, 2, 4, 8, 12, 24, 36 week after operation. 73%(73 eyes) of NSG and 27%(30 eyes) of DSG showed a myopia less than 6.0 diopters preoperatively. The proportion of male was 36% in NSG and 50.4% in DSG. 88.1% of male high myopia(>6.0 diopters) needed 0.1% fluorometholone, while 17.6% of female moderate and mild myopia(visual acuity, higher myopic regression measrured by spherical equivalent and higher incidence of corneal haziness than NSG. Conclusively it is not necessary to instill topical steroid to all female patients with myopia of 6.0 diopters or less after PRK and delayed starting of topical steroid is not able to prevent the myopic regression nor improve corneal haziness.