A prospective study on ocular hypertensive and antiinflammatory response to different dosages of fluorometholone in children.
OBJECTIVE
To investigate the ocular hypertensive and antiinflammatory response to different dosages of fluorometholone (FML).


METHODS
Prospective clinical trial with randomization of fellow eyes to different postoperative treatment.


METHODS
Thirty-one consecutive children undergoing bilateral symmetrical strabismus operation.


METHODS
Among 31 children who received bilateral squint operations, one eye was randomized to receive topical FML six times daily (group 1), whereas the other eye received topical FML three times daily (group 2), both for 4 weeks. Intraocular pressure (IOP) and antiinflammatory response were measured serially in the postoperative period for 8 weeks.


METHODS
Intraocular pressure was measured on the day before surgery and on postoperative days 1, 3, 6, 13, 20, 27, 41, and 55. The antiinflammatory response was also assessed subjectively and objectively at days 6, 13, 20, and 27 after the operations. Peak IOP, net increase in IOP, and antiinflammatory responses in the two study groups were analyzed.


RESULTS
Thirty-one children, age 3 to 9 years, (mean +/- standard deviation [SD], 5.52 +/- 1.81) participated in the study. Intraocular pressure increased significantly in both groups compared with the preoperative values (P < 0.001). The peak IOP ranged from 12.00 to 31.00 mmHg and 12.30 to 25.00 mmHg in groups 1 and 2, respectively. The mean peak IOP (19.00 +/- 5.06 mmHg vs. 17.13 +/- 3.32 mmHg) was significantly higher in group 1 (P < 0.001). The net increase in IOP was similar (mean +/- SD, 4.37 +/- 4.79 vs. 2.57 +/- 3.32 mmHg; P = 0.005). Ranges of the net IOP increase were -1.00 to 16.00 mmHg and -2.50 to 10.30 mmHg in groups 1 and 2, respectively. Children in group 1 reached the peak IOP earlier than those in group 2 (median, 6 vs. 13 days; P = 0.033). However, there was no significant difference in antiinflammatory response between the two groups.


CONCLUSIONS
Ocular hypertension occurs in a dose-dependent manner in children treated with FML. Children in group 1 had a quicker onset and more severe ocular hypertensive response than those in group 2. It would be desirable to monitor the IOP regularly when FML is used with a high frequency and for a long duration in children.
Fan
D S
DS
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong.
Ng
J S
JS
Lam
D S
DS
D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003231:Conjunctivitis / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005469:Fluorometholone / Q000008:administration & dosage / Q000009:adverse effects*; D005938:Glucocorticoids; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D013285:Strabismus / Q000601:surgery
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D005469:Fluorometholone