Diclofenac versus fluorometholone after strabismus surgery in children.
OBJECTIVE
To compare the effects of topical diclofenac sodium with those of fluorometholone on intraocular pressure (IOP) and conjunctival inflammation after strabismus surgery.


METHODS
We retrospectively analysed 60 Korean children who underwent strabismus surgery for intermittent exotropia in an institutional referral centre. Patients received topical diclofenac 0.1% or fluorometholone 0.1% after surgery for up to 4 weeks. IOP, patient discomfort, conjunctival inflammation and conjunctival injection were evaluated at 1, 2, 3 and 4 weeks after surgery.


RESULTS
In the fluorometholone group, 23% showed an increase of ≥10 mm Hg compared to the baseline IOP within 4 weeks of surgery. The fluorometholone group showed a significant change in IOP compared to baseline (p<0.001) at all follow-up time points, whereas the diclofenac group showed no significant increase in IOP. An increased risk of IOP elevation of ≥10 mm Hg was observed after fluorometholone use in patients under 7 years of age. There was no significant difference in patient discomfort, conjunctival inflammation or conjunctival injection between the two groups. Conjunctival injection was more pronounced with muscle resection than with recession at 1 month after surgery.


CONCLUSIONS
Postoperative topical diclofenac is an excellent substitute for steroids, particularly in young children under 7 years of age.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Hee Kyung
HK
Yang
Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Kangwon.
Sang Beom
SB
Han
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Jeong-Min
JM
Hwang
D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003231:Conjunctivitis / Q000188:drug therapy*; D004008:Diclofenac / Q000627:therapeutic use*; D005099:Exotropia / Q000601:surgery*; D005260:Female; D005469:Fluorometholone / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D014065:Tonometry, Ocular
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D004008:Diclofenac; D005469:Fluorometholone
Conjunctiva; Inflammation; Intraocular Pressure; Treatment Surgery