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Duration of topical steroid application after photorefractive keratectomy with mitomycin C
Mojgan Pakbin1, Mehdi Khabazkhoob, Mohammad Pakravan
1From the Noor Ophthalmology Research Center, Noor Eye Hospital (Pakbin), and Translational Ophthalmology Research Center, Tehran University of Medical Sciences (Pakbin), and Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences (Khabazkhoob), and Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences (Pakravan), and Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (Fotouhi), and Department of Optometry, School of Rehabilitation Science, Iran University of Medical Sciences (Jafarzadehpour), and Translational Ophthalmology Research Center, Tehran University of Medical Sciences (Aghamirsalim), and Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital (Seyedian), and Translational Ophthalmology Research Center, Tehran University of Medical Sciences (Hashemi), and Noor Ophthalmology Research Center, Noor Eye Hospital (Hashemi), Tehran, Iran.
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.
