Use of loteprednol for routine prophylaxis after photorefractive keratectomy

Abstract

Mark D Mifflin1, Lisa L Leishman1, Steven M Christiansen1, Shameema Sikder2, Maylon Hsu1, Majid Moshirfar11Department of Ophthalmology, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 2Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USABackground: The purpose of this work is to report our experience using loteprednol 0.5% for routine prophylaxis after photorefractive keratectomy in an academic refractive surgery center.Materials and methods: Photorefractive keratectomy was performed on 579 eyes from 316 patients in this retrospective chart review of patients treated postoperatively with either fluorometholone 0.1% (273 eyes) or loteprednol 0.5% (306 eyes). Primary outcome measures at 6 months included uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction spherical equivalent. Secondary outcome measures were incidence of corneal haze and increased intraocular pressure.Results: There were no statistically significant differences in preoperative characteristics between the two groups when comparing age, sex, best-corrected visual acuity, spherical equivalent, or keratometry. Both groups achieved excellent visual outcomes, with a mean uncorrected distance visual acuity (logMAR) of 0.004 ± 1.4 in the fluorometholone group and –0.028 ± 1.1 in the loteprednol group (P = 0.013) at 6 months. Postoperative corneal haze and increased intraocular pressure were uncommon and not statistically different between the groups.Conclusion: Loteprednol 0.5% performed similarly to fluorometholone 0.1% when used for prophylaxis following photorefractive keratectomy. The incidence of haze and increased intraocular pressure were similar between the two groups.Keywords: loteprednol, fluorometholone, photorefractive keratectomy