Gartry D S, Kerr Muir M, Marshall J
Department of Ophthalmology, St. Thomas' Hospital, London, UK.
Eye (Lond). 1993;7 ( Pt 4):584-90. doi: 10.1038/eye.1993.127.
Several thousands of myopic patients have undergone photorefractive keratectomy (PRK) worldwide (prior to the publication of long-term, carefully controlled studies). The evidence in support of the currently widespread use of topical corticosteroids after PRK, however, is limited. We report the results of a prospective, double-masked trial to determine the effect of dexamethasone 0.1% on refraction and anterior stromal haze following -3.00 and -6.00 dioptre PRK procedures (n = 113; minimum follow-up 1 year). Initially the reduction in myopia was significantly greater in the steroid group compared with the placebo group (p < 0.002). However, on discontinuing the corticosteroids at 3 months this difference became statistically insignificant (p > 0.2). There was no statistically significant effect on anterior stromal haze at any stage. We conclude that, in view of their side effects, it would be unacceptable to use topical corticosteroids in the long term to maintain the initial beneficial effect on refraction. We therefore consider that topical corticosteroids should not be used following PRK.
在全球范围内，数千名近视患者接受了准分子激光角膜切削术（PRK）（在长期、严格对照研究发表之前）。然而，支持目前PRK术后广泛使用局部皮质类固醇的证据有限。我们报告了一项前瞻性、双盲试验的结果，以确定0.1%地塞米松对-3.00和-6.00屈光度PRK术后屈光和前部基质 haze的影响（n = 113；最短随访1年）。最初，类固醇组近视的降低幅度明显大于安慰剂组（p < 0.002）。然而，在3个月时停用皮质类固醇后，这种差异在统计学上变得不显著（p > 0.2）。在任何阶段，对前部基质 haze均无统计学显著影响。我们得出结论，鉴于其副作用，长期使用局部皮质类固醇以维持对屈光的初始有益效果是不可接受的。因此，我们认为PRK术后不应使用局部皮质类固醇。
