Pharmacotherapy of photorefractive keratectomy.
OBJECTIVE
To compare the pharmacotherapeutic practices of high-volume photorefractive keratectomy (PRK) surgeons with suggested practices gleaned from the current literature.


METHODS
York Finch Eye Associates, Toronto, Canada.


METHODS
Seventy-five ophthalmic surgeons believed by the authors to do a high-volume of PRKs were surveyed over the summer of 1994 about their pharmacotherapeutic practices. The results were compared with suggested practices extracted from a review of the current literature.


RESULTS
Relatively consistent approaches to the management of post-PRK pain and prevention of acute post-PRK subepithelial infiltrative keratitis were reported. The administration of topical steroids after PRK was almost universally employed. Post-PRK analgesia was most commonly achieved with nonsteroidal anti-inflammatory drugs (NSAIDs) and a soft contact lens, but surgeons were not convinced of the benefits of long-term NSAID administration to control myopic regression and haze. There seemed to be no agreed-on solution to the infrequent problems of severe haze and regression and steroid-induced elevated intraocular pressure after PRK; however, many useful suggestions for the management of these problems were proposed.


CONCLUSIONS
In general, high-volume PRK surgeons use topical steroids, NSAIDs, and a soft contact lens in the immediate postoperative period, although they are uncertain about the long-term effectiveness of NSAIDs in controlling regression and haze.
York Finch General Hospital, Toronto, Canada.
S A
SA
Arshinoff
M D
MD
Mills
S
S
Haber
D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic; D003315:Cornea / Q000601:surgery*; D004333:Drug Administration Routes; D004358:Drug Therapy / Q000379:methods*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000700:Analgesics; D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D009883:Ophthalmic Solutions