Ocular-hypertensive and anti-inflammatory response to rimexolone therapy in children.
OBJECTIVE
To compare the ocular-hypertensive and anti-inflammatory response to rimexolone (116-hydroxy-16alphafluoro-6alphamethylpresdnisolone) and fluorometholone (21-deoxy-9alphafluoro-6alphamethylprednisolone) therapy in children's eyes.


METHODS
With parental consent, children who underwent surgical procedures for bilateral symmetric strabismus from January 18, 2000, through November 16, 2001, were recruited. One eye was randomized to receive topical 1% rimexolone while the contralateral eye received topical 0.1% fluorometholone, 4 times daily for 4 weeks.


METHODS
Intraocular pressures and anti-inflammatory responses were the main outcome measures and were serially measured postoperatively for 8 weeks.


RESULTS
Fifty-four children, aged from 4 to 8 years (mean [SD] age, 5.33 [1.26] years), participated in the study. Intraocular pressure increased significantly in both treatment groups compared with the preoperative values (P<.001). The mean (SD) peak intraocular pressure was significantly higher in the rimexolone-treated group, 19.7 (6.1) vs 17.6 (4.6) mm Hg (P<.001). Similarly, the mean (SD) net increase in intraocular pressure (P<.001), was also higher in the rimexolone-treated eyes, 5.9 (4.4) vs 3.9 (4.1) mm Hg (P<.001). In addition, a greater percentage of the rimexolone-treated patients had no conjunctival erythema on days 13 (11.1% vs 0.0%) and 20 (88.9% vs 55.6%) (P =.03).


CONCLUSIONS
Rimexolone seems to be a more effective anti-inflammatory agent than fluorometholone. However, unlike adults, the ocular-hypertensive effect in children treated with rimexolone was higher. It would be desirable to monitor the intraocular pressure regularly when rimexolone therapy is used in children.
Fan
Dorothy S P
DS
Departments of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon and the Prince of Wales Hospital, Shatin, New Territory, Hong Kong. dorothyfan@cuhk.edu.hk
Yu
Christopher B O
CB
Chiu
Thomas Y H
TY
Wong
Chun Yu
CY
Ng
Joan S K
JS
Pang
Chi Pui
CP
Lam
Dennis S C
DS
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005469:Fluorometholone / Q000008:administration & dosage / Q000009:adverse effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced*; D009883:Ophthalmic Solutions; D011245:Pregnadienes / Q000008:administration & dosage / Q000009:adverse effects*; D013285:Strabismus / Q000601:surgery
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D011245:Pregnadienes; C013769:rimexolone; D005469:Fluorometholone