Comparing the Effect of Loteprednol 0.5% versus Fluorometholone 1.0% on Intraocular Pressure after Photorefractive Keratectomy (PRK)

To compare the effect of loteprednol 0.5% versus fluorometholone 1.0% on intraocular pressure (IOP) after photorefractive keratectomy (PRK).
PRK was performed in 124 eyes of 62 participants; one eye of each participant randomly received loteprednol 0.5% and the fellow eye had fluorometholone 1.0% postoperatively. Participants were followed up for three months postoperatively. Ocular discomfort and redness, ocular pain, visual outcomes, corneal haze, and IOP were compared between the two groups after surgery.
There was no significant difference between the two groups in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction at the end of follow up. At postoperative 3 month, UDVA >20/25 was achieved in 95% of the loteprednol group and 92% of the fluorometholone group (p > 0.05). Neither visually significant corneal haze nor ocular hypertension (IOP rise >10 mmHg or IOP > 21 mmHg) was seen in any group. The mean IOP was 13.7±2.2 mmHg in the loteprednol group and 13.7±2.0 mmHg in the fluorometholone group preoperatively (p > 0.05). No significant change was observed in IOP in the study groups at postoperative months 1 and 2. However, IOP was similarly decreased (1±2.2 mmHg) in both groups at postoperative month 3. There was a significant association preoperative IOP and reduction in IOP at postoperative month 3 (regression coefficient = -0.56). No significant correlation was found between preoperative spherical equivalent and reduction in central corneal thickness postoperatively. The participants of both groups had ocular pain for 2.0 ± 1.60 days on average (0 to 7 days). No participant reported ocular discomfort or eye redness after they commenced the drugs.
No significant difference was observed between loteprednol 0.5% and fluorometholone 1.0% in efficacy and side effects, especially high IOP, after PRK.