J Korean Ophthalmol Soc.  2017 Jul;58(7):846-851. 10.3341/jkos.2017.58.7.846.

Effects of Corneal Toxicity and Conjunctival Injection of Preservative-free 0.1% Fluorometholone after Pediatric Strabismus Surgery

• Kim SY
• Chun BY

• KMID: 2387159
• DOI: http://doi.org/10.3341/jkos.2017.58.7.846

Abstract

PURPOSE
To compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery.
METHODS
A randomized, prospective clinical study was performed to compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. Sixty-one patients with intermittent exotropia were included in this study. They were told to apply antibiotic eye drops (ED) and either preservative or preservative-free topical 0.1% fluorometholone (F1) three times a day. Measurements of the degrees of conjunctival injection and corneal toxicity were performed at postoperative 1 week and 3 weeks each.
RESULTS
Seventeen patients (34 eyes) were included in group 1 (preservative F1) and twenty patients (40 eyes) were included in group 2 (preservative-free F1). The average pixel value (measured via the Image J software) representing the degree of conjunctival injection was 31,732 ± 9,946 in group 1 and 38,347 ± 12,189 in group 2 at postoperative 1 week, while the average pixel value was 10,150 ± 4,493 in group 1 and 11,836 ± 4,290 in group 2 at postoperative 3 weeks. There was a significant difference between the decrease in pixel value for the two groups (p = 0.040). There was no significant difference in the mean value of the Oxford stain score between the two groups at postoperative 3 weeks, however the mean questionnaire scores in group 2 were significantly lower than in group 1 (p = 0.001).
CONCLUSIONS
Preservative-free 0.1% fluorometholone ED demonstrated a larger decrease in the degree of conjunctival injection than for preservative ED after strabismus surgery. Therefore, the use of preservative-free steroid ED may be beneficial for decreasing both conjunctival injection and postoperative discomfort following strabismus surgery.

Keyword

Conjunctival injection; Fluorometholone; Preservative-free; Strabismus surgery

MeSH Terms

Clinical Study
Exotropia
Fluorometholone*
Humans
Ophthalmic Solutions
Prospective Studies
Strabismus*
Fluorometholone
Ophthalmic Solutions

Figure

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  Figure 1. Method of image analysis. (A) The conjunctival image was taken by image capture system and was recorded as an JPG image. (B) An region of interest (ROI) (red square in A) was selected as the evaluation area. (C) A binarized image of the ROI.

Reference

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