Investigation on the effect of topical corticosteroids as adjunctive plan in the therapy of bacterial corneal ulcers / 中国基层医药

ABSTRACT

Objective To investigate the clinical efficacy and safety of topical corticosteroids as adjunctive plan in the therapy of bacterial corneal ulcers (BCU).Methods 62 eligible patients with confirmed BCU were screened and divided into 2 groups randomly.Both groups were treated with topical tobramycin for 3 weeks,the observation group received topical tobramycin for at least 48 hours and then treated with 0.02％ fluorometholone for 3 weeks,and decrement setp by step.Best spectacle corrected visual acuity(BSCVA),fluctuation of intraocular pressure (IOP) before and after therapy,time to corneal reepithelialization and clarity,severe adverse event were observed.Results After 3 weeks,BSCVA of both groups increased compared to their baselines,however,no significant difference between the two groups.Patients whose IOP exceed 21mm Hg in the control group was statistically more than that in the observation group(x2 =7.272,P ＜ 0.05).Follow up for 3 months,increasing of BSCVA in the observationgroup was significantly higher than the control group(t =2.388,P ＜ 0.05) ;and lOP of both two groups almost recuperated to baselines.Although the time to corneal reepithelialization of the control group (11.3 ± 4.5) d was shorter than observation group [(14.7 ± 5.2) d] (t =2.707,P ＜ 0.05),the recovery of corneal clarity in observation group was superior to control group (x2 =8.207,P ＜ 0.05).In addition,no severe adverse events were observed during this period.Conclusion Although prolong the healing time of corneal epithelium,corticosteroids as an adjunctive plan in the therapy of BCU may reduce immune-mediated damage,decrease scarring,control IOP fluctuation and improve BSCVA,but with no safety concerns.