title: The effect of early steroid treatment after PRK on clinical and refractive outcomes.
abstract: OBJECTIVE
  To evaluate the effects of steroid treatment administered in the first days after excimer laser keratectomy (PRK) on re-epithelialization time, postoperative pain, haze and refractive outcome.
  
  
  METHODS
  A randomised, double masked trial was carried out on two groups of patients (40 patients each), who underwent PRK. Group A (steroid group) received 0.1% fluorometholone acetate whereas group B (NSAID group) received 0.5% ketorolac tromethamine until re-epithelialization was completed. Subsequently, all 80 patients received the same steroid treatment: 0.1%, fluorometholone acetate for myopic corrections up to -5 D, or dexamethasone for myopic corrections exceeding -5 D. Both drugs were tapered off over approximately 3 months. Follow-up examinations were planned at 1, 3, 6, 12 months after surgery.
  
  
  RESULTS
  Re-epithelialization was completed after three days, without any significant difference between groups. A higher hyperopic shift was shown in the steroid group and a more severe regression was reported in the NSAID group (p<0.001). Haze was significantly reduced in the steroid group (p=0.005), especially for myopic corrections over -5 D (p=0.015). Pain was significantly reduced in the NSAID group (p=0.002).
  
  
  CONCLUSIONS
  Steroid eyedrops administered in the first days after PRK did not affect re-epithelialization time. Moreover, a modulation of the inflammatory response in this period appears to reduce haze and myopic regression in high myopic patients.
authors.affiliation: Eye Institute, Department of Ophthalmology-Otorhinolaryngology, University of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vetrugno
authors.forename: A
authors.initials: A
authors.lastname: Maino
authors.forename: G M
authors.initials: GM
authors.lastname: Quaranta
authors.forename: L
authors.initials: L
authors.lastname: Cardia
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003315:Cornea / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D003907:Dexamethasone / Q000627:therapeutic use; D004311:Double-Blind Method; D019573:Epithelium, Corneal / Q000502:physiology; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use; D006801:Humans; D020911:Ketorolac Tromethamine / Q000627:therapeutic use; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009883:Ophthalmic Solutions; D010149:Postoperative Pain / Q000517:prevention & control; D018903:Photorefractive Keratectomy; D012029:Refraction, Ocular / Q000187:drug effects; D014792:Visual Acuity / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine; D003907:Dexamethasone; D005469:Fluorometholone