Comparison of the efficacy between non-steroidal and steroidal anti-inflammatory drugs after thin-flap LASIK

Abstract

Objective To compare the efficacy between non-steroidal and steroidal anti-inflammatory drugs after a thin-flap LASIK procedure. Methods This was a prospective, randomized and controlled clinical study. Three hundred fourteen patients (628 eyes) who were undergoing thin-flap LASIK were enrolled in the study. They were randomly divided into a loteprednol group and a bromfenac group. Best uncorrected visual acuity, refractive status, intraocular pressure (IOP) and the cornea were examined preoperatively and 3 days, 15 days, 1 month and 3 months after the LASIK procedure. The differences in visual acuity, refraction and IOP between the groups were compared using repeated measures categorical data analysis. The ratios of uncorrected visual acuity (UCVA) to best corrected visual acuity (BCVA) at the time points after surgery were compared using a mixed linear model, and the incidence of diffuse lamellar keratitis (DLK) was compared with a chi-square test. Results The ratios of UCVA to BCVA between the groups were not statistically significant (F=0.717, P>0.05) . The spherical lens power and IOP in the loteprednol and bromfenac groups were 0.04±0.68 D and 0.16±0.58 D, and 14.67±4.00 mmHg (1 mmHg=0.133 kPa) and 10.91±2.40 mmHg, respectively. The differences were statistically significant (F=6.184, P 0.05). Conclusion Bromfenac can be a safe and effective substitute for loteprednol as anti-inflammation eyedrops after thin-flap LASIK. By reducing the incidence of a postoperative spike in IOP, bromfenac is beneficial for stabilizing refractive status in patients. Key words: Keratomileusis, laser in situ; Anti-inflammatory agents, non-steroidal; Visual acuity; Intraocular pressure; Refraction, ocular