Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1% in the first year after descemet membrane endothelial keratoplasty
Price MO, Price FW, Kruse F, Bachmann B, Tourtas T (2014)
Publication Type: Journal article
Publication year: 2014
Journal
Book Volume: 33
Pages Range: 880-6
Journal Issue: 9
DOI: 10.1097/ICO.0000000000000206
Abstract
The aim of this study was to compare the efficacy and side effects of prednisolone acetate 1% versus fluorometholone 0.1% after Descemet membrane endothelial keratoplasty (DMEK).DMEK recipients used prednisolone acetate 1% for 1 month, and they were randomized to either prednisolone or fluorometholone for months 2 through 12. Dosing was 4 times daily in months 1 to 3, thrice daily in month 4, twice daily in month 5, and once daily in months 6 to 12. The main outcomes were immunologic rejection episodes and intraocular pressure (IOP) elevation (defined as >=24 mm Hg or >=10 mm Hg increase over the preoperative baseline level), assessed by the Kaplan-Meier survival analysis.The study included 325 eyes (99% were white, 96% had Fuchs dystrophy, and 9% had a previous glaucoma diagnosis). No eyes (0%) assigned to prednisolone versus 2 eyes (1.4%) assigned to fluorometholone experienced a possible (n = 1) or probable (n = 1) rejection episode (P = 0.17). Both rejection episodes resolved successfully with increased topical steroids. In the prednisolone arm, a significantly higher proportion exceeded the defined IOP elevation threshold (22% vs. 6%, P = 0.0005), and glaucoma medications were initiated or increased more often (17% vs. 5%, P = 0.0003). The most frequent reasons for discontinuing the assigned intervention were IOP management (n = 13 eyes assigned to prednisolone) or inflammation management (n = 3 eyes assigned to fluorometholone). One-year endothelial cell loss was comparable in both arms (30% vs. 31%, P = 0.50).DMEK has a remarkably low rejection episode rate (<1% through 1 year), as confirmed in this prospective randomized study. This provides a unique opportunity to reduce postoperative topical corticosteroid strength and thereby reduce the risk of steroid-associated complications.
Authors with CRIS profile
Involved external institutions
Price Vision Group
United States (USA) (US)
Cornea Research Foundation of America
United States (USA) (US)
United States (USA) (US)
Cornea Research Foundation of America
United States (USA) (US)
How to cite
APA:
Price, M.O., Price, F.W., Kruse, F., Bachmann, B., & Tourtas, T. (2014). Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1% in the first year after descemet membrane endothelial keratoplasty. Cornea, 33(9), 880-6. https://doi.org/10.1097/ICO.0000000000000206
MLA:
Price, Marianne O., et al. "Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1% in the first year after descemet membrane endothelial keratoplasty." Cornea 33.9 (2014): 880-6.
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