A randomized controlled trial comparing dexamethasone with loteprednol etabonate on postoperative photorefractive keratectomy

J Ocul Pharmacol Ther. 2015 Apr;31(3):165-8. doi: 10.1089/jop.2014.0107. Epub 2015 Jan 2.

Abstract

Purpose: To compare loteprednol etabonate 0.5%/tobramycin 0.3% (Zylet(®)) with dexamethasone 0.1%/tobramycin 0.3% (Tobradex(®)) in terms of the epithelial healing time, postoperative visual acuity, corneal haziness score, and intraocular pressure (IOP) in postoperative treatment after photorefractive keratectomy (PRK).

Methods: This prospective, randomized, double-masked (participants and assessors blinded) controlled study included 32 patients who underwent PRK. The patients were allocated equally into 2 groups by block randomization to receive either loteprednol etabonate (Lot) or dexamethasone (Dex) for 1 month after the surgery. The epithelial healing time, uncorrected visual acuity (UCVA), corneal haziness score, and IOP were evaluated at 1 week, 1 month, and 3 months.

Results: The corneal epithelium was healed within 3 days in both groups; however, the epithelium was closed on the second day in 3 cases in the Lot group compared with 1 case in the Dex group. No significant differences were found for UCVA at 1 and 3 months (Fisher exact test, P>0.01). Similarly, there was no statistically significant difference in corneal haziness scores between the 2 groups at 1 and 3 months (Mann-Whitney U test, P>0.05). The number of patients experiencing significantly increased IOP (≥5 mmHg) from baseline at any visit for the Lot group (1/16 patients) was fewer than for the Dex group (3/16 patients).

Conclusions: Loteprednol etabonate was effective in postoperative PRK management and was significantly less likely to produce elevations in IOP than was dexamethasone.

Trial registration: ClinicalTrials.gov NCT01724892.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • Dexamethasone / administration & dosage*
  • Dexamethasone / adverse effects
  • Double-Blind Method
  • Epithelium, Corneal / drug effects
  • Female
  • Humans
  • Intraocular Pressure / drug effects
  • Loteprednol Etabonate / administration & dosage*
  • Loteprednol Etabonate / adverse effects
  • Male
  • Photorefractive Keratectomy / adverse effects
  • Photorefractive Keratectomy / methods*
  • Postoperative Care / methods
  • Prospective Studies
  • Wound Healing / drug effects
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone
  • Loteprednol Etabonate

Associated data

  • ClinicalTrials.gov/NCT01724892