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. 2017 Jun 12:11:1113-1118.
doi: 10.2147/OPTH.S138272. eCollection 2017.

Efficacy and safety of a 3-month loteprednol etabonate 0.5% gel taper for routine prophylaxis after photorefractive keratectomy compared to a 3-month prednisolone acetate 1% and fluorometholone 0.1% taper

Mark D Mifflin  1 , Brent S Betts  1 , P Adam Frederick  2 , Jason M Feuerman  3 , Carlton R Fenzl  4 , Majid Moshirfar  1   5 , Brian Zaugg  1
Affiliations

Efficacy and safety of a 3-month loteprednol etabonate 0.5% gel taper for routine prophylaxis after photorefractive keratectomy compared to a 3-month prednisolone acetate 1% and fluorometholone 0.1% taper

Mark D Mifflin et al. Clin Ophthalmol. .

Abstract

Purpose: To compare the outcome of photorefractive keratectomy (PRK) and complications in patients treated with either loteprednol etabonate 0.5% gel or prednisolone acetate 1% suspension and fluorometholone (fml) 0.1% suspension.

Setting: John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA.

Design: Prospective, randomized, partially masked trial.

Methods: PRK was performed on 261 eyes of 132 participants. Patients were randomized to a postoperative corticosteroid regimen of either loteprednol etabonate 0.5% gel (loteprednol) or prednisolone 1% acetate suspension followed by fluorometholone 0.1% suspension (prednisolone/fml). Primary outcome measures included incidence and grade of postoperative corneal haze and incidence of increased intraocular pressure of 10 mmHg above baseline, or any intraocular pressure over 21 mmHg. Secondary outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity, and manifest refraction spherical equivalent.

Results: The incidence of haze in the first 3 months was 2.6% (3/114 eyes) in the loteprednol group and 4.8% (7/147 eyes) in the prednisolone/fml group and was not statistically significant between groups (P=0.37). The incidence of elevated intraocular pressure was 1.8% (2/114 eyes) in the loteprednol group and 4.1% (6/147 eyes) in the prednisolone/fml group, and was not statistically significant between the groups (P=0.12). The mean 3-month postoperative logMAR uncorrected visual acuity was -0.078±0.10 and -0.075±0.09 in the loteprednol and prednisolone/fml groups, respectively (P=0.83).

Conclusion: Postoperative corneal haze and elevated intraocular pressure were uncommon in both treatment arms. There was no statistically significant difference between each postoperative regimen. Refractive results were similar and excellent in both treatment arms. A tapered prophylactic regimen of loteprednol 0.5% gel is equally effective to prednisolone 1%/fml 0.1% after PRK.

Keywords: PRK; corticosteroid; fluorometholone; lotemax; loteprednol; wavefront optimized.

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Conflict of interest statement

Disclosure None of the authors have a financial or proprietary interest in any material or method mentioned. The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Pre- and postoperative visual acuity expressed in logMAR. Abbreviations: BCVA, best corrected visual acuity; UCVA, uncorrected visual acuity; postop, postoperative; fml, fluorometholone.
See this image and copyright information in PMC

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