Ocular hypertensive and anti-inflammatory responses to different dosages of topical dexamethasone in children: a randomized trial.
BACKGROUND
The purpose of the present study was to investigate the ocular hypertensive and anti-inflammatory responses to two different dosage schedules of 0.1% topical dexamethasone in a population of Chinese children undergoing strabismus surgery.


METHODS
Children undergoing bilateral strabismus surgeries were randomly assigned to receive topical 0.1% dexamethasone eye drops four times daily (group A) or twice daily (group B) for 4 weeks. Intraocular pressure (IOP) and anti-inflammatory responses were monitored for 8 weeks.


RESULTS
A total of 137 children with mean age 6.5 years (SD, 1.9 years; range, 3-10 years) participated in the study. The IOP increased significantly after 4 weeks in both groups compared to the preoperative values (P < 0.001). Peak IOP ranged from 14.0 to 50.3 mmHg in group A and 11.0-41.3 mmHg in group B. Cases in group A (mean, 13.8 mmHg; SD, 8.4 mmHg) had a greater net increase in IOP than cases in group B (mean, 10.2 mmHg; SD, 6.2 mmHg; P = 0.004). Younger-aged children had higher peak IOP (r = -0.244, P = 0.048), and attained the peak IOP earlier (r = 0.252, P = 0.041) in group A. There was no significant difference in ocular inflammatory response between the two groups.


CONCLUSIONS
Ocular hypertensive effect to topical 0.1% dexamethasone is dose and age dependent in children. Twice-daily 0.1% topical dexamethasone eye drops control inflammation after strabismus surgery as effectively as four-times-daily dosage, but induces less increase in IOP, and may be a better treatment schedule.
Lam
Dennis S C
DS
Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, Chinese University of Hong Kong, Kowloon, Hong Kong. dennislam_pub@cuhk.edu.hk
Fan
Dorothy S P
DS
Ng
Joan S K
JS
Yu
Christopher B O
CB
Wong
Chun Y
CY
Cheung
Albert Y K
AY
D000367:Age Factors; D044466:Asian People / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D003231:Conjunctivitis / Q000208:ethnology / Q000517:prevention & control*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000208:ethnology; D011183:Postoperative Complications / Q000517:prevention & control; D013285:Strabismus / Q000208:ethnology / Q000601:surgery; D014065:Tonometry, Ocular
D005938:Glucocorticoids; D003907:Dexamethasone