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July 1992

The Effect of Topical Corticosteroids on Refractive Outcome and Corneal Haze After Photorefractive Keratectomy: A Prospective, Randomized, Double-Blind Trial

Author Affiliations

From the Department of Ophthalmology, St Thomas' Hospital, London, England. Dr Gartry received a research fellowship sponsored by The Iris Fund for Prevention of Blindness, London; Drs Gartry, Kerr Muir, and Lohmann have no proprietary interest in the subject matter of this article. Dr Marshall is a consultant for Summit Technology, Waltham, Mass, and has an equity interest in the company.

Arch Ophthalmol. 1992;110(7):944-952. doi:10.1001/archopht.1992.01080190050028

• In this study, we report the results of a prospective, double-blind trial to determine whether high-dose topical corticosteroids have an effect on refractive outcome or anterior stromal haze after photorefractive keratectomy. A total of 113 patients were allocated randomly to either placebo- or steroid-treated groups (0.1% dexamethasone metasulphobenzoate for 3 months) and underwent either −3.00-diopter (D) or −6.00-D procedures. At 6 weeks, the mean change in refraction was significantly greater in the steroid-treated group than in the placebo-treated group (−3.00-D group, P=.0015; −6.00-D group, P=.0001). However, when corticosteroids were discontinued at 3 months, this difference became statistically insignificant. There was no statistically significant effect on anterior stromal haze at any stage. Since long-term use of corticosteroids to maintain the initial beneficial effect on refraction would be unacceptable, we conclude that these agents should not be used after photorefractive keratectomy.