The effect of topical corticosteroids on laser-induced peripheral anterior synechiae.
OBJECTIVE
To assess the influence of different topical steroid agents and a non-corticosteroid medication after Argon laser trabeculoplasty (ALT) on the development of peripheral anterior synechiae (PAS) and the reduction of intraocular pressure (IOP).


METHODS
In two separate prospective, randomised, group-controlled studies, topical fluorometholone 0.1% (FML Liquifilm) was compared with dexamethasone 0.1% (Maxidex) (Study A), or naphazoline hydrochloride 0.1% (Albalon) (Study B) after ALT for chronic open-angle glaucoma, with particular reference to the formation of PAS and the IOP response.


RESULTS
In Study A (N = 109) eyes treated with Maxidex had a significantly higher incidence of PAS than those treated with FML - 45% compared with 22%, P < 0.05 (normal deviate test). In Study B (N = 75) the incidence of PAS was equal in eyes treated with FML or Albalon (23%). In the two studies combined (N = 184), the development of PAS was associated with a significantly lower mean response of IOP to ALT - 1.47 mmHg compared with 3.22 mmHg, 0.01 < P < 0.05 (Student t-test).


CONCLUSIONS
The incidence of PAS after ALT is significantly higher with the post-laser use of Maxidex than with FML, and is the same for Albalon as for FML. The therapeutic benefit of ALT is significantly reduced if PAS develop.
West
R H
RH
Melbourne University Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Australia.
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery; D005938:Glucocorticoids; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects; D007499:Iris Diseases / Q000517:prevention & control*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009278:Naphazoline / Q000627:therapeutic use; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D000267:Tissue Adhesions / Q000517:prevention & control; D014130:Trabeculectomy / Q000009:adverse effects
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone; D009278:Naphazoline; D005469:Fluorometholone