Prophylaxis of diffuse lamellar keratitis with intraoperative interface steroids in LASIK
| Autor: | Michael O'Keefe, Eugene Y J Ng, Frank Kinsella, Sashin Thinagaran |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity medicine.medical_treatment Prednisolone Keratomileusis Laser In Situ Keratomileusis Stage ii Dexamethasone Port (medical) medicine Myopia Humans Glucocorticoids Diffuse lamellar keratitis Keratitis Intraoperative Care business.industry LASIK medicine.disease Cannula Surgery Ophthalmology Hyperopia Female Lasers Excimer medicine.symptom business medicine.drug |
| Zdroj: | Journal of refractive surgery (Thorofare, N.J. : 1995). 25(3) |
| ISSN: | 1081-597X |
| Popis: | Purpose: To investigate the safety and efficacy of intraoperative interface steroids for the prophylaxis of diffuse lamellar keratitis (DLK). Methods: Two centers analyzed 1210 consecutive procedures in a prospective interventional trial. Center A irrigated the lasered stromal bed with balanced salt solution (BSS), instilled a drop of preserved dexamethasone 0.1% suspension on the stromal bed, and replaced the corneal flap. Center B replaced the flap, inserted a multiple port cannula to irrigate the stromal interface with BSS, then introduced 0.5 mL preservative-free prednisolone sodium phosphate 0.5% solution into the stromal interface with another multiple port cannula. All LASIK procedures after a fixed date received intraoperative interface steroids. Consecutive procedures immediately before this date were used as controls. Results: Center A performed 405 intraoperative interface steroids procedures and contributed 405 controls. Center B performed 200 intraoperative interface steroids procedures and contributed 200 controls. Preoperative refraction and postoperative visual acuity were similar in control and intraoperative interface steroids groups. In center A, 5.7% (30% were stage II) and 2% (all only stage I) of controls and intraoperative interface steroid eyes, respectively, developed DLK; intraoperative interface steroids decreased the rate of DLK by 3.0 times (95% confidence interval: 1.3 to 6.8). In center B, 6.5% of controls developed DLK (15% were stage II); with intraoperative interface steroids, only 1 procedure (0.5%) developed DLK. In both centers, no bilateral DLK or DLK beyond stage I were noted when intraoperative interface steroids were used. Conclusions: Intraoperative interface steroids safely reduced the incidence and severity of DLK. [ J Refract Surg. 2009;25:306–311.] |
| Databáze: | OpenAIRE |
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