Use of loteprednol for routine prophylaxis after photorefractive keratectomy

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.

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.

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.

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.