Duration of topical steroid application after photorefractive keratectomy with mitomycin C
Mojgan Pakbin1 *, Mehdi Khabazkhoob 2 , Mohammad Pakravan 3 , Akbar Fotouhi 4 , Ebrahim Jafarzadehpour 5 , Mohamadreza Aghamirsalim 6 , Mohammad Amin Seyedian7 , Hassan Hashemi 8
- 1. Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran.
2. Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Optometry, School of Rehabilitation Science, Iran University of Medical Sciences, Tehran, Iran.
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Noor Ophthalmology Research center, Noor Eye Hospital, Tehran, Iran.
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
Abstract: To compare the effect of different durations of steroid administration after photorefractive keratectomy (PRK) on corneal haze (CH).
Methods: Electronic databases including PubMed, Scopus, Web of Sciences, Embase, and Cochrane Library were searched to find studies related to steroid administration in PRK surgery. The main outcomes were CH and post-op spherical equivalent (SE). Pooled unstandardized mean difference (PUMD) was estimated using fixed effects and random effect models when necessary.
Results: Seven studies were included. The overall PUMD of the CH score was -0.20 (95% CI, -0.29 to -0.12). In subgroup analysis, the PUMD of the CH score was statistically significant in 2 subgroups, -0.57 (-0.85 to -0.30) for 3-6 months after surgery and -0.13 (-0.23 to -0.04) for ≤ 3 months postoperatively. The PUMD of the CH score was higher in < -6.00 D group.
The overall PUMD of post-operative SE between steroid and control groups was estimated 0.43 (95% CI 0.21 to 0.66). This difference was 0.52 (0.27 to 0.77) and 0.46 (0.01 to 0.91) for SD ≥ 3 and follow-up (F/U) ≤ 6 months, and SD <3 and F/U > 6 months, respectively.
Analysis of the PUMD of post-op SE in participants with low to moderate myopia (≥ -6.00 D) and high myopia (< -6.00 D) showed positive effects of steroid on prevention of myopia regression.
Conclusion: Long term topical steroid application after PRK seems unnecessary in low and moderate myopia. New randomized clinical trials using current technologies are recommended for post-operative treatments.
