The effect of Timolol 0.5% on the correction of myopic regression after LASIK

Abstract

Backgroud:Postlaser in situ keratomileusis (post-LASIK) refractive regression is defined as the gradual, partial, or total loss of initial correction that limits the predictability, efficiency, and long-term stability of LASIK. Our study assesses the effect of Timolol 0.5% on the correction of myopic regression after LASIK.Methods:This prospective, randomized, controlled study included 62 eyes of 62 patients with myopic regression of −1.18 ± 0.86 diopters (D) after myopic LASIK. They were randomly assigned into either Group 1 who received Timolol 0.5% eye drops for 3 months or Group 2 who received artificial tears as control (during treatment). Patients were followed an additional 2 months after cessation of eye drops treatment (posttreatment).Results:During treatment in Group 1, as the mean true intraocular pressure (IOPT) lowered significantly, regression stopped. As the mean IOPT increased significantly posttreatment and returned to its pretreatment level, regression recurred. The effective rate of Timolol therapy dropped from 62.5% during treatment to 40.6% posttreatment. On the contrary in Group 2, although the mean IOPT did not change significantly, regression continually happened as time passed. During treatment, the mean IOPT, uncorrected visual acuity, spherical equivalent (SE), and corneal refractive power showed significant difference between the 2 groups. In Group 1, the differences of effective rate of Timolol therapy between each of the 2 subgroups of age, gender, preoperative SE (PSE), or pretreatment time (how long we start treatment with Timolol post-LASIK) were not statistically significant.Conclusion:IOP-lowering eye drop Timolol was effective for the correction of myopic regression when a 0.5-D or greater myopic shift is detected after LASIK in patients regardless of age, gender, PSE, or anytime we started the treatment only if regression happened. However, the myopic regression recurred after cessation of Timolol treatment.

Reduction of corneal epithelial thickness during medical treatment for myopic regression following FS-LASIK

“…Studies have reported a relationship between the elevation of intraocular pressure (IOP) and corneal protrusion, and demonstrated that topical anti-glaucoma eye drops were effective in correcting approximately 0.5 diopter (D) of refractive regression. This was presumably a result of lowered IOP leading to the backward movement of the cornea and the flattening of its curvature [ 4 – 7 ]. On the other hand, steroid eye drops have long been used to decrease myopic regression after photorefractive keratectomy (PRK), as myopic regression has been known to be related to wound healing [ 8 , 9 ].…”

Complications of laser-assisted in situ keratomileusis

“…Management includes IOP lowering agents like timolol that reduces anterior shift of cornea. [ 86 ] However, the effect is temporary and reverts on cessation of treatment. Surgical treatment options include LASIK enhancement, PRK, and laser-assisted sub-epithelial keratomileusis (LASEK).…”

Refractive regression after laser in situ keratomileusis

“…More recently, Qi et al also conducted a prospective randomized, controlled study of 62 eyes which were randomly assigned to either timolol 0.5% twice daily or artificial tears. 76 Each group received treatment for 3 months and were subsequently followed for an additional 2 months. The authors also found that timolol was effective for the reducing myopic regression of −1.18 AE 0.86D (range −0.5 to −6.63 D).…”