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Use of loteprednol for routine prophylaxis after photorefractive keratectomy

Authors Mifflin M, Leishman, Christiansen S, Sikder S, Maylon Hsu, Moshirfar M

Received 27 January 2012

Accepted for publication 5 March 2012

Published 1 May 2012 Volume 2012:6 Pages 653—659

DOI https://doi.org/10.2147/OPTH.S30282

Review by Single-blind

Peer reviewer comments 3


Mark D Mifflin1, Lisa L Leishman1, Steven M Christiansen1, Shameema Sikder2, Maylon Hsu1, Majid Moshirfar1
1Department of Ophthalmology, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 2Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA

Background: The purpose of this work is to report our experience using loteprednol 0.5% for routine prophylaxis after photorefractive keratectomy in an academic refractive surgery center.
Materials and methods: Photorefractive keratectomy was performed on 579 eyes from 316 patients in this retrospective chart review of patients treated postoperatively with either fluorometholone 0.1% (273 eyes) or loteprednol 0.5% (306 eyes). Primary outcome measures at 6 months included uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction spherical equivalent. Secondary outcome measures were incidence of corneal haze and increased intraocular pressure.
Results: There were no statistically significant differences in preoperative characteristics between the two groups when comparing age, sex, best-corrected visual acuity, spherical equivalent, or keratometry. Both groups achieved excellent visual outcomes, with a mean uncorrected distance visual acuity (logMAR) of 0.004 ± 1.4 in the fluorometholone group and –0.028 ± 1.1 in the loteprednol group (P = 0.013) at 6 months. Postoperative corneal haze and increased intraocular pressure were uncommon and not statistically different between the groups.
Conclusion: Loteprednol 0.5% performed similarly to fluorometholone 0.1% when used for prophylaxis following photorefractive keratectomy. The incidence of haze and increased intraocular pressure were similar between the two groups.

Keywords: loteprednol, fluorometholone, photorefractive keratectomy

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