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| The Effect of Different Potency Glucocorticosteroids Treatments on Corneal Densitometry and Corneal Epithelial Thickness after SMILE |
| Xuewen Ren, Likun Xia |
| Clinic Center of Myopia, Shengjing Hospital of China Medical University, Shenyang 110000, China |
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Abstract Objective: To compare the effect of different potency glucocorticosteroids on corneal densitometry and corneal epithelial thickness after small incision lenticule extraction (SMILE). Methods: In this prospective clinical study, totally 101 patients (197 eyes) were collected from July 2020 to October 2021 and randomly assigned to dexamethasone group (51 patients, 99 eyes) and fluorometholone group (50 patients, 98 eyes). For the dexamethasone group, patients were treated with topical dexamethasone eye drops 4 times daily for 1 week, changed to topical fuorometholone eye drops 3 times to 1 time per day with a drop decrease per week for 3 weeks after SMILE. For the fuorometholone group, patients were treated with topical fuorometholone eye drops 4 times to 1 time per day with a drop decrease per week for 1 month postoperatively. The corneal densitometry of surgical plane, corneal epithelial thickness, intraocular pressure, uncorrected visual acuity, total high order aberrations and contrast sensitivity were examined before SMILE and at 1 day, 1 week, 1 month postoperatively. t test or U test were used to compare the differences between two groups. Results: Finally, 42 patients (82 eyes) in dexamethasone group and 43 patients (84 eyes) in fuorometholone group completed follow-up. There was no statistical difference in preoperative basal data, spherical equivalent refraction, central corneal thickness and other surgical parameters between two groups (P>0.05). There were no significant differences of corneal densitometry between two groups at preoperatively, 1 day and 1 month postoperatively (P>0.05). The corneal densitometry of dexamethasone group was lower than fluorometholone group at 1 week postoperatively (t=-3.96, P=0.011). At preoperatively and 1 month postoperatively, there were no differences in intraocular pressure between two groups (P>0.05). At 1 week postoperatively, intraocular pressure of dexamethasone group was remarkably higher than fluorometholone group (Z=-3.86, P<0.001). At preoperatively and 1 day and 1 month postoperatively, there were no differences in corneal epithelial thickness between two groups (P>0.05). Corneal epithelial thickness of dexamethasone group in 0-2 mm region (t=-2.89, P=0.005) and >2-5 mm region (t=-3.48, P=0.001) were thinner than the fuorometholone group at 1 week postoperatively. At 1 week and 1 month after surgery, contrast sensitivity was better than in dexamethasone group (P<0.05). No differences were found in postoperative uncorrected visual acuity, total higher order aberration, the effective index and safety index between two groups at any following-up time points (P>0.05). Conclusions: Comparing of low potency steroids, high potency steroids inhibited corneal epithelial remodeling obviously, had better effects in recovery of corneal densitometry and contrast sensitivity at early postoperation. However, high potency steroids had a tendency increase intraocular pressure. The postoperative dosing regimen combining high-efficiency and low-acting corticosteroids can help patients achieve faster, safer and more effective postoperative recovery.
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Received: 08 May 2022
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| Fund:Key R &D Project of Liaoning Province in 2022 (2020JH2/10300135) |
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Corresponding Authors:
Likun Xia, Clinic Center of Myopia, Shengjing Hospital of China Medical University, Shenyang 110000, China (Email: xialk@sj-hospital.org)
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| [1] |
. [J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 0-. |
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