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Jun Shimazaki, Seika Den, Ayumi Harashima, Yoshiyuki Satake; Efficacy and Safety of Long-term Use of Steroid Eyedrops Following Penetrating Keratoplasty; A Prospective, Randomized Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1633.
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To investigate the efficacy and safety of the long-term use of steroid eyedrops following penetrating keratoplasty in a prospective, randomized study.
Patients underwent penetrating keratoplasty and maintained the graft clarity for more than 1 year with the use of steroid eyedrops were randomly assigned to; use 0.1%fluoromethorone eyedrops t.i.d. (steroid group, n=19) or discontinue steroid eyedrops (no steroid group, n=19). They were followed-up for more than one year. Graft clarity, development of immunological rejection, best spectacle corrected visual acuity (BSCVA), intraocular pressure, epithelial damage, conjunctival culture, and other complications were monitored prospectively.
No differences were noted with regard to age, gender, original diseases between the two groups. Four eyes in the steroid group were dropped out from the study because of the suture break (n=2), intraocular pressure rise (n=1), and discontinuation of steroids due to self-judgment (n=1). Six eyes in the no steroid group were dropped out due to suture break (n=3), retinal detachment (n=1), self-judgment (n=1), and patent’s death (n=1). At one-year follow-up, graft clarity rate was not significantly different (100% in steroid group and 85% in the no steroid group, P=0.21). However, the incidence of rejection was significantly higher in the no steroid group (46%) than steroid group (46% vs. 7%, P=0.016). Two eyes in the no steroid group showed irreversible endothelial decompensation following rejection. No significant differences were noted in BSCVA, intraocular pressure, and epithelial damage grading at the one-year follow-up. Although one eye in the steroid group showed intraocular pressure rise, it returned to normal after discontinuation of the steroid. Three eyes in the steroid group showed positive conjunctival culture, however, no infection signs were noted.
Long-term use of steroid eyedrops (0.1% fluoromethorone t.i.d.) was effective for the suppression of rejection even more than 1 year after keratoplasty.
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