Comparative study of the intraocular pressure effects of fluorometholone 0.1% versus dexamethasone 0.1%.

The intraocular pressure effect of fluorometholone 0.1% was compared with that of dexamethasone 0.1% by performing corticosteroid provocative tests on 24 matched pairs of eyes. Fifteen of the 24 dexamethasone treated eyes, 62.5%, showed a change in intraocular pressure greater than 5 mmHg, with mean delta P = 8.58 mmHg and range 0 to +20 mmHg. Only 2 of the 24 fluorometholone treated eyes, 8.3%, showed a change in pressure greater than 5 mmHg, with mean delta P = 2.96 mmHg and range -2 to +14 mmHg. There was a highly statistically significant difference between the intraocular pressure effects of topical dexamethasone and fluorometholone (correlated t test, p less than 0.001). Fluorometholone would appear to be the topical steroid of choice for patients with glaucoma and other known steroid responders when topical steroid treatment is indicated.     

Marked intraocular pressure response to instillation of corticosteroids in children

We examined intraocular pressures of patients with strabismus whose eyes were instilled with corticosteroid eyedrops after a strabismus operation. Group A consisted of 11 children under 10 years of age whose eyes were instilled with 0.1% dexamethasone; Group B consisted of nine patients 10 years old or older whose eyes were instilled with 0.1% dexamethasone; and Group C consisted of 13 children under 10 years of age whose eyes were instilled with 0.1% fluorometholone. In Group A, four patients had intraocular pressures greater than 30 mm Hg, five had intraocular pressures from 21 to 30 mm Hg, and two had intraocular pressures under 21 mm Hg one or two weeks postoperatively. The intraocular pressure decreased to less than 21 mm Hg one week after discontinuation of dexamethasone treatment in all nine patients. No patients in Groups B or C had intraocular pressures greater than 20 mm Hg. Our results suggest that marked ocular hypertensive response to 0.1% dexamethasone treatment occurs frequently in children under 10 years of age.     

Intraocular pressure response to topical dexamethasone as a predictor for the development of primary open-angle glaucoma

In a retrospective study we reviewed the records of 788 subjects who had been corticosteroid tested with 0.1% dexamethasone four times daily to one eye for six weeks. All subjects had normal kinetic visual fields and optic nerve heads in both eyes at the time of testing and were followed up for a minimum of five years. Some subjects had normal baseline intraocular pressures whereas others were considered to have ocular hypertension. Of 276 individuals who were high corticosteroid responders (intraocular pressure greater than 31 mm Hg during dexamethasone administration), 36 (13.0%) developed glaucomatous visual field loss during the follow-up period. Only nine of 261 individuals (3.4%) who were intermediate responders (intraocular pressure 20 to 31 mm Hg during dexamethasone administration) and none of 251 individuals who were low responders (intraocular pressure less than 20 mm Hg during dexamethasone administration) developed glaucomatous visual field loss. However, the ability of the intraocular pressure response to dexamethasone to predict the development of glaucomatous visual field loss was not as good as the predictive power of a multivariate model that included patient age, race, baseline intraocular pressure, baseline outflow facility, baseline cup/disk ratio, and systemic hypertension.     

Subtenon's depot corticosteroid injections in patients with a history of corticosteroid-induced intraocular pressure elevation.

PURPOSE: To determine whether a history of intraocular pressure elevation from local corticosteroid administration could predict subsequent intraocular pressure elevation after posterior subtenon's corticosteroid injection. METHODS: A retrospective review was performed of 64 consecutive patients (64 eyes) receiving posterior subtenon's corticosteroid injection. Patients were categorized as either historical corticosteroid responders or nonresponders based on intraocular pressure response to topical corticosteroid drops in the same eye or to previous posterior subtenon's corticosteroid injection of the fellow eye. Historical responders were defined as having a relative intraocular pressure increase of 5 mm Hg and absolute intraocular pressure greater than 24 mm Hg with an anatomically open angle. Relative risk of intraocular pressure elevation was evaluated based on historical response and presenting diagnosis. RESULTS: Nine eyes were historical responders, and 55 eyes were historical nonresponders. A higher rate of recurrent intraocular pressure elevation developed in historical responder eyes (4 of 9, 44%) compared with nonresponders (7 of 55, 13%) after posterior subtenon's injection (P = .04, Fisher's test; P = .07, Kaplan-Meier analysis). Historical responders with uveitis were at significantly higher risk of intraocular pressure elevation than nonresponders without uveitis (hazard ratio = 10.8, P = .04, Cox proportional hazards). All but one eye that developed intraocular pressure elevation from posterior subtenon's injection was adequately controlled with topical antiglaucoma therapy. CONCLUSION: In nonglaucomatous eyes, a previous history of corticosteroid-induced intraocular pressure elevation is a relative, not absolute, contraindication to posterior subtenon's corticosteroid injection, because the risk of intraocular pressure elevation is not absolute, and because it can usually be well controlled with topical antiglaucoma therapy.     

SMILE术后不同效价激素治疗对角膜光密度值和角膜上皮厚度的影响

目的：比较飞秒激光小切口角膜基质透镜取出术（SMILE）后不同效价激素治疗下的角膜光密度值和角膜上皮厚度（CET）的差异。方法：前瞻性临床研究。连续性收集2020年7月至2021年10月就诊于中国医科大学附属盛京医院近视诊疗中心的近视及近视散光患者101例（197眼）。将患者根据随机数字表法,随机分为地塞米松组51例（99眼）和氟米龙组50例（98眼）。地塞米松组术后使用妥布霉素地塞米松滴眼液4次/d点眼,每次1滴,用药1周,1周后改为氟米龙滴眼液3次/d,每次1滴,每周减量1次,至术后1个月时停药。氟米龙组术后使用氟米龙滴眼液和妥布霉素滴眼液,均4次/d点眼,每次1滴,1周后停用妥布霉素滴眼液,并继续使用氟米龙滴眼液3次/d,每次1滴,每周减量1 次,至术后1个月时停药。在术前及术后1 d、1周、1个月分别测量2组患者手术层面的角膜光密度值、CET、眼压及视力等。采用独立样本t检验或U检验比较2组数据间不同随访时间点的差异。结果：最终地塞米松组和氟米龙组分别有42例（82眼）和43例（84眼）完成随访。2组基本信息、术前等效球镜度差异均无统计学意义（P>0.05）。在术前和术后1 d、1个月时,2组角膜光密度值差异无统计学意义（P>0.05）;在术后1周时,地塞米松组角膜光密度值低于氟米龙组,差异有统计学意义（t=-3.96, P=0.011）。在术前和术后1个月时,2组眼压值差异无统计学意义（P>0.05）;在术后1周时,地塞米松组眼压明显高于氟米龙组,差异有统计学意义（Z=-3.86,P<0.001）。术前和术后1 d、1个月时,2组CET差异均无统计学意义（P>0.05）;术后1周时,地塞米松组在0~2 mm（t=-2.89,P=0.005）和>2~5 mm区域t=-3.48,P=0.001）CET低于氟米龙组。术前时,2组在亮环境和暗环境下的对比敏感度差异无统计学意义（P>0.05）;在术后1周时和1个月时,地塞米松组的对比敏感度优于氟米龙组,差异有统计学意义（P<0.05）。2组术前及术后不同时间点的裸眼视力、总高阶像差、术后有效指数和安全指数的差异均无统计学意义（均P>0.05）。结论：与使用低效价糖皮质激素相比,SMILE术后早期使用高效价激素明显抑制了角膜上皮重塑,角膜光密度值和对比敏感度恢复更快。SMILE术后患者使用高效价激素眼压升高更明显。术后高效价与低效价糖皮质激素相结合的给药方案,能够帮助患者获得更快、更安全有效的术后恢复。     

准分子激光角膜屈光术后皮质类固醇性高眼压临床相关因素分析

目的:探讨准分子激光角膜屈光术后皮质类固醇性高眼压的发生率、临床相关凶素及预后.方法:对2005-12/2006-12间行LASIK或LASEK的2060例4060眼滴糖皮质激素眼液(1g/L地塞米松及1g/L氟米龙)2～3mo,术后1wk;1,2,3,6mo及1α观察眼压变化,对高眼压者进行治疗,并采用Logistic方法分析高眼压与年龄、性别、眼别、最大径线屈光度、最大径线角膜曲率、角膜切削深度和眼底垂直径杯/盘比值的相关性.结果:有88例143眼发生了高眼压,发生率为3.5%,所有高眼压患者经药物治疗眼压均降至正常.Logistic回归分析结果显示,眼底杯/盘比值与高眼压相关性P值为0.015,OR值为3.071,其他因素P值均大于0.1.眼底垂直径杯/盘比值大于等于0.4者发生皮质类固醇性高眼压的几率是小于0.4者的3.071倍.结论:准分子激光角膜屈光术后应用糖皮质激素眼液可引起部分患者发生皮质类固醇性高眼压,眼底垂直径杯/盘比值与皮质类固醇性高眼压有较强相关性,大于等于0.4是皮质类固醇性高眼压的高危因素,对眼底杯/盘比值大于等于0-4者术后可酌情减少激素用量和/或加用降眼压药物.     

Effect of fluorometholone (FML) on the intraocular pressure of corticosteroid responders.

Steroid responsiveness to dexamethasone was determined in a large family with an established dominant form of chronic simple glaucoma. The high and intermediate steroid responders were then tested with fluorometholone--a steroid which is claimed to have a reduced risk of increasing intraocular pressure. It was found that fluorometholone had a much less pronounced ocular hypertensive effect than dexamethasone. However, one patient showed a comparable response on both drugs, and this suggests that some caution must still be exercised when using the drug on susceptible individuals. Fluorometholone was also found to be more irritable to the eye than dexamethasone.     

Intraocular pressure response to corticosteroids in children.

A total of 44 children who suffered from vernal conjunctivitis were treated with topical dexamethasone 0.1% 4 times daily for 6 weeks and tested for their intraocular pressure. There was a statistically significant difference (P less than 0.01) between the responders in our group of children and a group of normal adults reported on by Armaly in 1965.     

Experimental study of an automated system for the delivery of eyedrops using a microinfusion pump

PURPOSE: To determine the feasibility of using a commercially available microinfusion pump for the continuous delivery of eye drops using a rabbit model. DESIGN: Laboratory investigation. METHODS: Tear secretion was measured after attaching a microinfusion pump to the superior fornix of a rabbit. The pump was set to deliver artificial tears continuously. A rabbit eye was first chemically burned with 1N NaOH, the pump was then set to deliver 0.1% fluorometholone continuously. Results were compared with those obtained using 0.1% fluorometholone. RESULTS: Schirmer tests indicated that an average of 22.3 mm in eyes supported by a pump and an average of 10.3 mm in eyes without pump. Moreover, eyes treated with corticosteroid delivered by pump recovered faster than those treated with topical corticosteroid. CONCLUSIONS: The continuous delivery of eye drops by a microinfusion pump could be applicable to patients with severe dry eyes or ocular surface diseases. Further study should be needed.     

Efficacy of nedocromil 2% versus fluorometholone 0.1%: a randomised, double masked trial comparing the effects on severe vernal keratoconjunctivitis

AIMS: To compare the efficacy of topical nedocromil 2% with fluorometholone 0.1% in vernal keratoconjunctivitis (VKC). METHODS: In a double masked random design, 24 patients with severe vernal keratoconjunctivitis were placed at random on nedocromil 2% eye drops in one eye and fluorometholone 0.1% in the fellow eye. At the end of the 2 week treatment period, the patient crossed over the eye drops (if asymptomatic in one eye), or continued with nedocromil sodium in both eyes (if asymptomatic in both eyes). All patients were examined weekly and ocular surface temperature recorded for a period of 6 weeks. RESULTS: Improvement in the watering, discharge, conjunctival hyperaemia, papillary hypertrophy, and Trantas' dots was noted in both groups, but overall fluorometholone was significantly more effective than nedocromil. Eyes treated with fluorometholone showed a significant decrease in ocular surface temperature compared with nedocromil treated eyes (p = 0.03). CONCLUSIONS: Both nedocromil and fluorometholone were effective in ameliorating the signs and symptoms of vernal keratoconjunctivitis. No adverse effects were noted in the nedocromil group.     

Efficacy and safety of desonide phosphate for the treatment of allergic conjunctivitis

PURPOSE: To study the safety and efficacy of the topical corticosteroid, desonide 0.25% ophthalmic solution, for inhibition of the clinical allergic reaction induced by conjunctival provocation (CPT) and for the treatment of seasonal allergic conjunctivitis (SAC). METHODS: For the CPT study, 12 allergic but inactive patients were exposed in both eyes to increasing doses of a specific allergen until a positive bilateral, symmetrical early- and late-phase reaction was obtained. After 2 weeks the last positive dose was readministrated and their positive response confirmed. After an additional 2 weeks, CPT was performed 30 minutes after topical administration of desonide in one eye and placebo in the contralateral eye (Group A) or after topical desonide or placebo four times a day for 2 days (Group B). Clinical signs and symptoms were recorded after 15, 30, and 60 minutes, and after 6 hours. Regarding the seasonal study, 96 patients with active SAC were treated bilaterally with either desonide or fluorometholone for 3 weeks, and allergic signs and symptoms evaluated at regular intervals. The safety of the drugs was assessed by identification of any side effects or adverse events of any kind. RESULTS: For the CPT study: individual itching and redness, and the sum score for signs and symptoms were all statistically (p < 0.05) and clinically (greater than 1 change between treated eyes) significantly lower in desonide versus placebo eyes. Both early- and late-phase reactions were reduced by desonide pretreatment. Seasonal study: desonide and fluorometholone were both highly effective in reducing itching, tearing, and conjunctival hyperemia over time (p < 0.0001). Both drugs appeared safe, with no statistically significant changes in IOP observed with either treatment. CONCLUSIONS: Desonide has a significant therapeutic effect on both the induced conjunctival early- and late-allergic reaction and in active SAC. It was also safe, with no side effects such as increases in intraocular pressure observed by physician or patient.     

Steroid glaucoma: corticosteroid-induced ocular hypertension in cats.

This study was undertaken to develop a feline model of corticosteroid-induced ocular hypertension. In the first experiment, eight cats were selected whose intraocular pressure (17 +/- 0.4 mmHg) was consistently below the mean baseline intraocular pressure of our colony (24 +/- 0.5) during the preceding 2 months. Unilateral twice or thrice daily topical application of 10 microliters 1% dexamethasone sodium phosphate caused a gradual intraocular pressure increase that became significant (P less than 0.05) within 2-3 weeks. There was no significant change in body weight, but several eyes developed cataracts. Similar results were obtained with treatment of normotensive cat eyes with dexamethasone, or with 1.0% prednisolone acetate (PredForte) twice a day. Topical application of PGF2 alpha-1-isopropyl ester (0.1 or 0.25 microgram PG equivalent) to such steroid-treated eyes yielded significant intraocular pressure reduction and pupillary miosis, similar in magnitude to those exhibited by normal eyes. When dexamethasone treatment was reduced to once daily, after prolonged twice daily treatment, intraocular pressure decreased only slightly within 10 days. When dexamethasone treatment was stopped, intraocular pressure declined to normal levels within 6-7 days. These findings show that adult cat eyes develop steroid-induced ocular hypertension that is maintained and reversible. As opposed to previous findings on rabbits, steroid-induced feline ocular hypertension appears to be a good model for this clinical condition and may be suitable for the testing of potential glaucoma drugs.     

Clinical trial of Timoptic used for inhibiting the development of keratoconus

A 0.5% Timoptic was used in 37 patients with a keratoconus during 2 weeks, one drop twice a day to both eyes; the day measurements of the intraocular pressure were subsequently repeated. The mean upper value of P after drops was 14.595 +/- 2.522 mm Hg for the R. eye and 14.139 +/- 2.113 mm Hg for the L. eye. The mean day oscillations in the R. eye amounted 3.378 +/- 1.441 mm Hg and in the L. eye 3.333 +/- 1.042 mm Hg. The differences in daily oscillations of P before and after drops were statistically significant. After excluding from the analysis 4 patients who did not react to Timoptic one compared 12 eyes in which the objective improvement was evident with 21 eyes without improvement. These two groups differed in respect of daily oscillations of P before application of the drops--p less than 0.004.     

Comparison of topical 0.7% dexamethasone–cyclodextrin with 0.1% dexamethasone sodium phosphate for postcataract inflammation

Background To compare 0.7% dexamethasone–cyclodextrin aqueous eye drop solution applied once daily with 0.1% dexamethasone sodium phosphate eye drops applied three times a day for the control of postoperative inflammation after cataract surgery.Methods Twenty cataract patients who underwent phacoemulsification and intraocular lens implantation were randomly divided into two postoperative treatment groups. Postoperative medication in group I included 0.1% dexamethasone sodium phosphate eye drops three times daily and in group II 0.7% dexamethasone–cyclodextrin eye drop solution once daily. Testing of visual acuity, biomicroscopic examination, applanation tonometry and laser flare cell meter (LFCM) examination were carried out before operation and days 1, 3, 7 and 21 after surgery.Results Preoperative and postoperative visual acuity, aqueous flare and cells in biomicroscopic examination, and the mean intraocular pressure did not show any statistically significant differences between the treatment groups. LFCM examination showed that the mean postoperative photon count values (P=0.032) and the median cell count values on the 1st (P=0.014), 3rd (P=0.031), 7th (P=0.034), and 21st (P=0.0097) postoperative days in group I were more elevated than in group II.Conclusions 0.7% dexamethasone–cyclodextrin eye drops applied once daily is a more effective postoperative anti-inflammatory medication than 0.1% dexamethasone sodium phosphate applied three times a day. In both groups, 3 weeks after the operation the mean visual acuity was normal and intraocular pressure significantly lower than before operation. The use of 0.7% dexamethasone–cyclodextrin eye drops may be useful especially in elderly people who cannot apply themselves the eye drops onto the eye.     

The effect of topical corticosteroids on laser-induced peripheral anterior synechiae.

Purpose: To assess the influence of different topical steroid agents and a non-corticosteroid medication after Argon laser trabeculoplasty (ALT) on the development of peripheral anterior synechiae (PAS) and the reduction of intraocular pressure (IOP). Method: In two separate prospective, randomised, group-controlled studies, topical fluorometholone 0.1% (FML Liquifilm) was compared with dexamethasone 0.1% (Maxidex) (Study A), or naphazoline hydrochloride 0.1% (Albalon) (Study B) after ALT for chronic open-angle glaucoma, with particular reference to the formation of PAS and the IOP response. Results: In Study A (N = 109) eyes treated with Maxidex had a significantly higher incidence of PAS than those treated with FML - 45% compared with 22%, P < 0.05 (normal deviate test). In Study B (N = 75) the incidence of PAS was equal in eyes treated with FML or Albalon (23%). In the two studies combined (N = 184), the development of PAS was associated with a significantly lower mean response of IOP to ALT - 1.47 mmHg compared with 3.22 mmHg, 0.01 < P < 0.05 (Student t-test). CONCLUSION: The incidence of PAS after ALT is significantly higher with the post-laser use of Maxidex than with FML, and is the same for Albalon as for FML. The therapeutic benefit of ALT is significantly reduced if PAS develop.     

准分子激光屈光性角膜切削术后皮质类固醇性高眼压和青光眼的临床分析

目的探讨准分子激光屈光性角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ,ＰＲＫ）后皮质类固醇性高眼压（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｏｃｕｌａｒｈｙｐｅｒｔｅｎｓｉｏｎ）及皮质类固醇性青光眼（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｇｌａｕｃｏｍａ）的发生率、临床特征及治疗效果。方法用美国ＶＩＳＸ２０／２０准分子激光系统,对ＰＲＫ术后１５９０只眼滴用皮质类固醇（０．１％氟米龙）眼液４～６个月,分别于术后１个月、３个月、６个月、１年及２年观察眼压变化,对于高眼压者给予治疗。结果本组１５９０只眼中４３只眼发生皮质类固醇性高眼压或皮质类固醇性青光眼,发生率为２．７％。经停用皮质类固醇眼液,滴用０．５％噻吗心安（或０．５％盐酸左布诺洛尔）眼液,必要时口服醋氮酰胺或行小梁切除术等,眼压均降至正常。结论ＰＲＫ术后滴用皮质类固醇眼液可发生皮质类固醇性高眼压及皮质类固醇性青光眼,个别患者视功能损害严重。对此,应停用皮质类固醇眼液,滴用β受体阻滞剂眼液或和口服碳酸酐酶抑制剂等;对视功能严重损害、停用降眼压药后眼压仍较高的患眼应行小梁切除术,经治疗眼压均可降至正常。     

三种抗炎药物在Nd：YAG激光后囊膜切开术后应用的随机对照研究

背景Nd：YAG激光后囊膜切开术是治疗后发性白内障的重要手段,通常术后常规使用糖皮质激素滴眼液点眼以减轻患者术眼的前房炎症反应,但这存在升高眼压的潜在风险。目的比较氯替泼诺混悬滴眼液、妥布霉素地塞米松滴眼液和氟米龙滴眼液在Nd：YAG激光后囊膜切开术后局部应用的抗炎效果及对眼压的影响。方法采用随机对照研究设计,对接受Nd：YAG激光后囊膜切开术的127例患者171眼按随机数字表法随机分为4个组：氯替泼诺组35例47眼,采用氯替泼诺混悬滴眼液点眼;氟米龙组30例40眼,使用氟米龙滴眼液点眼;妥布霉素地塞米松组29例38眼,给予妥布霉素地塞米松滴眼液点眼;聚乙二醇组33例46眼,使用聚乙二醇滴眼液点眼。4个组均于Nd：YAG激光后囊膜切开术后开始点眼,每日6次,连续使用5d。分别于术前1h及术后1h、1d、3d、1周使用Glodmann眼压计测量眼压,在裂隙灯显微镜下按照Peizeng的标准对术眼的前房炎症反应程度进行评分。结果氯替泼诺组术眼术前1h,术后1h、1d、3d及1周的平均眼压分别为（18．2±4．7）、（20．1±5．7）、（18．7±5．5）、（19．0±4．1）和（19．5±3．5）mmHg;氟米龙组分别为（18．7±5．3）、（20．9±5．7）、（21．3±4．5）、（21．0±4．9）、（22．5±6．5）mmHg;妥布霉素地塞米松组分别为（17．9±6．3）、（20．3±6．1）、（23．0±3．7）、（24．7±4．9）、（24．5±6．5）mmHg;聚乙二醇组分别为（18．4±6．3）、（20．7±3．7）、（22．7±6．5）、（19．6±4．8）、（18．5±3．5）mmHg,4个组术眼眼压的总体比较差异有统计学意义（F组别3．876,P：0．023）;随着时间的延长,氯替泼诺组和聚乙二醇组眼压逐渐下降,而氟米龙组和妥布霉素地塞米松组眼压均高于术前,总体比较差异有统计学意义（F时间=3．801,P=0．031）。各组均未见其他明显眼部和全身药物相关性不良反应。氯替泼诺组和妥布霉素地塞米松组用药后房水细胞分级为1级和2级的百分比明显低于氟米龙组和聚乙二醇组,差异有统计学意义（H=8．276,P=0．012）;氯替泼诺组术眼I级房水闪辉的百分比为8％,氟米龙组为22％,妥布霉素地塞米松组为18％,聚乙二醇组为30％,各组房水闪辉严重程度的总体比较差异有统计学意义（H=9．305,P=0．000）。结论Nd：YAG激光后囊膜切开术后局部使用糖皮质激素能有效减轻患者术眼的前房炎症反应,其中氯替泼诺滴眼液抗炎疗效更好,对眼压影响较小,不良反应少,可作为Nd：YAG激光后囊膜切开术后的常规局部用药。     

准分子激光屈光性角膜切削术后皮质类固醇性高眼压和青光眼的 …

目的 探讨准分子激光屈光性角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ,ＰＲＫ）后皮质类固醇性高眼压（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｏｃｕｌａｒｈｙｐｅｒｔｅｎｓｉｏｎ）及皮质类固醇性青光眼（ｃｏｒｔｉｃｏｓｔｅｒｏｉｄｇｌａｕｃｏｍａ）的发生率,临床特征及治疗效果。方法 用美国ＶＩＳＸ２０／２０准分子激光系统,对ＰＲＫ术后１５９０只眼滴用皮质类固醇（０．１％氟米龙）眼液４－６个     

The effect of topical corticosteroids on laser-induced peripheral anterior synechiae

Purpose : To assess the influence of different topical steroid agents and a non-corticosteroid medication after Argon laser trabeculoplasty (ALT) on the development of peripheral anterior synechiae (PAS) and the reduction of intraocular pressure (IOP).
Method : In two separate prospective, randomised, group-controlled studies, topical fluorometholone 0.1% (FML Liquifilm) was compared with dexamethasone 0.1% (Maxidex) (Study A), or naphazoline hydrochloride 0.1% (Albalon) (Study 6) after ALT for chronic open-angle glaucoma, with particular reference to the formation of PAS and the IOP response.
Results : In Study A ( N =109) eyes treated with Maxidex had a significantly higher incidence of PAS than those treated with FML—45% compared with 22%, P <0.05 (normal deviate test).
In Study B ( N =75) the incidence of PAS was equal in eyes treated with FML or Albalon (23%).
In the two studies combined ( N =184), the development of PAS was associated with a significantly lower mean response of IOP to ALT—1.47 mmHg compared with 3.22 mmHg, 0.01< P <0.05 (Student t -test).
Conclusion : The incidence of PAS after ALT is significantly higher with the post-laser use of Maxidex than with FML, and is the same for Albalon as for FML. The therapeutic benefit of ALT is significantly reduced if PAS develop.     

Similarity of the intraocular pressure response to different corticosteroid esters when compliance is controlled

Fifty-four subjects with initial intraocular pressures under 20 mm Hg received a different commercial corticosteroid ester of prednisolone or dexamethasone in each eye for three to six weeks. Compliance was controlled. The intraocular pressure responses of the two eyes of a subject were similar. It was concluded that the absorptions of all four corticosteroids were in excess of the minimum amounts needed to maximally elevate pressure. Subjects complained that prednisolone acetate was irritating. Corticosteroid-induced uveitis developed in 3% (3) of the eyes.