Duration of topical steroid application after photorefractive keratectomy with mitomycin C

J Cataract Refract Surg. 2020 Apr;46(4):622-632. doi: 10.1097/j.jcrs.0000000000000060.

Abstract

Contradictory results of postoperative steroid application in photorefractive keratectomy (PRK) led to a meta-analysis of the existing data to achieve a definite conclusion on the optimum dosage and duration of corticosteroid therapy after PRK. The overall pooled unstandardized mean difference (PUMD) of the corneal haze score was -0.20 (95% CI, -0.29 to -0.12). In subgroup analysis, the PUMD of the corneal haze score was statistically significant in 2 subgroups, -0.57 (-0.85 to -0.30) for 3 to 6 months postoperatively and -0.13 (-0.23 to -0.04) for ≤ 3 months postoperatively. Analysis of the PUMD of postoperative spherical equivalent in participants with low to moderate myopia (≥-6.00 D) and high myopia (<-6.00 D) showed positive effects of steroids on prevention of myopia regression. In conclusion, long-term topical steroid application after PRK seems unnecessary in low and moderate myopia. New randomized clinical trials using current technologies are recommended for postoperative treatments.

Publication types

  • Systematic Review

MeSH terms

  • Administration, Ophthalmic
  • Alkylating Agents / administration & dosage*
  • Glucocorticoids / administration & dosage*
  • Humans
  • Lasers, Excimer / therapeutic use*
  • Mitomycin / administration & dosage*
  • Ophthalmic Solutions
  • Photorefractive Keratectomy*
  • Refraction, Ocular / physiology
  • Time Factors
  • Visual Acuity / physiology

Substances

  • Alkylating Agents
  • Glucocorticoids
  • Ophthalmic Solutions
  • Mitomycin