Topical Steroids in Bacterial Keratitis, A Retrospective Cohort Study.

Abstract

Purpose: To review the outcomes, risk factors and morbidity of bacterial keratitis treated with and without topical steroids. Design and Methods: Retrospective cohort study. Demographics, risk factors, culture results, ulcer characteristics, time to epithelialization, visual-acuity and recurrences were recorded. Patients were classified into 2 groups: 1.Topical antibiotics/steroids (ASG), 2.Antibiotics only group (AOG). Results: Seventy two eyes were identified; 37 were classified in the ASG and 35 in the AOG. Predisposing factors were identified in 87.5% of cases, Penetrating keratoplasty, previous surgery, contact-lens wear and Herpes-simplex keratitides were the most common overall; Microorganisms were indentified in 85.5% and 60% of ASG and AOG respectively. Epithelialization was completed at a mean 17.62 and 16.06 days in ASG and AOG respectively (p= 0.533); Final mean BSCVA was 1.59±1.07 and 1.64±1.21 logMAR in ASG and AOG respectively (p= 0.864). The number of gained Snellen lines was 0.13±0.22 in ASG and 0.14±.0.24 in AOG (p= 0.860). There were no recurrences. Conclusion: Although a non statistical significant delay in re-epithelialization was noted in the ASG, this did not translate into a statistical difference in final BSCVA, gained Snellen lines or recurrence of infection. In our series, adjuvant topical steroids were not associated with an increase in unfavorable outcomes.