ABSTRACT.Purpose: To evaluate the effects of steroid treatment administered in the first days after excimer laser keratectomy (PRK) on re-epithelialization time, postoperative pain, haze and refractive outcome. Methods: A randomised, double masked trial was carried out on two groups of patients (40 patients each), who underwent PRK. Group A (steroid group) received 0.1% fluorometholone acetate whereas group B (NSAID group) received 0.5% ketorolac tromethamine until re-epithelialization was completed. Subsequently, all 80 patients received the same steroid treatment: 0.1% fluorometholone acetate for myopic corrections up to ª5 D, or dexamethasone for myopic corrections exceeding -5 D. Both drugs were tapered off over approximately 3 months. Follow-up examinations were planned at 1, 3, 6, 12 months after surgery. Results: Re-epithelialization was completed after three days, without any significant difference between groups. A higher hyperopic shift was shown in the steroid group and a more severe regression was reported in the NSAID group (p∞0.001). Haze was significantly reduced in the steroid group (pΩ0.005), especially for myopic corrections over ª5 D (pΩ0.015). Pain was significantly reduced in the NSAID group (pΩ0.002). Conclusion: Steroid eyedrops administered in the first days after PRK did not affect re-epithelialization time. Moreover, a modulation of the inflammatory response in this period appears to reduce haze and myopic regression in high myopic patients.

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Aim-To evaluate the eVect of a high dose vitamin A and E supplementation on corneal re-epithelialisation time, visual acuity and haze following photorefractive keratectomy (PRK). Methods-Two groups of 20 patients who underwent myopic PRK were supplemented with either 25 000 IU retinol palmitate and 230 mg tocopheryl nicotinate or a placebo. Clinical outcomes were evaluated up to 360 days. Results-In the vitamin treated group, re-epithelialisation time was significantly faster (p=0.029) and haze incidence was reduced (p=0.035), especially for high myopic corrections (p=0.043). This group also reported a significantly better uncorrected visual acuity (p=0.043). Conclusions-High dose vitamin A and E oral supplementation may accelerate reepithelialisation time and may reduce corneal haze formation after PRK. (Br J Ophthalmol 2001;85:537-539) Corneal haze and myopic regression are the main undesirable complications after excimer laser treatment.

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Fluorometholone 0.1% acetate was effective on inflammation after PRK, with the same efficacy as fluorometholone 0.2%.