Author/Authors :
Karimian, Farid shahid beheshti university of medical sciences, تهران, ايران , Yurdkhani, Hossein shahid beheshti university of medical sciences, تهران, ايران , Anisian, Arash shahid beheshti university of medical sciences, تهران, ايران , Mohammadpour, Mehrdad shahid beheshti university of medical sciences, تهران, ايران , Yazdani, Shahin shahid beheshti university of medical sciences, تهران, ايران
Abstract :
Purpose: To determine the role of prophylactic topical steroids in the prevention ofdiffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK).Methods: This randomized double blind clinical trial included consecutive LASIKcandidates aged 18 to 55 years with stable (≥1 year) myopia ranging from -2 to -12 diopters.The day before surgery, eyes were randomly allocated to topical betamethasone0.1% or placebo every four hours. One hour preoperatively, the dosage was increased toevery five minutes for at least six times. DLK was graded according to the Linebarger-Lindstorm classification. Patients were examined one week and one and three monthsafter surgery. Best-corrected visual acuity (BCVA), manifest and cycloplegic refractionand severity of DLK were documented at each visit by a masked examiner.Results: Overall, 198 eyes (100 in the treatment group and 98 in the control group) of 101patients (97 bilateral and 4 unilateral cases) were operated. Pre- and post-LASIKrefraction and BCVA were comparable in the study groups (P 0.05). There were nosignificant complications in either group during or after LASIK except for DLK whichdeveloped in 55 eyes (55%) of the treatment group including 44 eyes with grade I and 11eyes with grade II, versus 36 eyes (36.7%) of the control group including 29 eyes withgrade I and 7 eyes with grade II DLK (P= 0.81).Conclusion: Although steroids play a key role in the treatment of DLK, pretreatmentwith topical steroids 24 hours prior to LASIK does not seem prevent this complication.
