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The efficacy of hourly prophylactic steroids in diffuse lamellar keratitis epidemic
- Source :
- Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 218(5)
- Publication Year :
- 2003
-
Abstract
- Purpose: To investigate the inciting agent, clinical features, and the efficacy of hourly steroids in the prophylaxis in a diffuse lamellar keratitis (DLK) epidemic. Methods: One hundred and five eyes of 58 patients that had DLK after LASIK were included in the study. To identify the cause of the epidemic, some interventions were made: irrigation solution was changed from BSS to Ringer lactate (week 5), wiping of the interface with a sponge was discontinued (week 6), the air conditioner in the LASIK room was checked (week 6), the routine postoperative topical regimen was changed from fluoromethalone and fluoroquinolones 4 times a day to hourly prednisolone acetate or dexamethasone sodium and fluoroquinolones (week 7), and the trademark of the drape used was changed (week 12). Results: There was no statistical difference in any of the attack rates associated with variables including BSS versus Ringer lactate (9.9 vs. 14%, p = 0.4), and air conditioner check with wiping versus not wiping the interface with the microsurgical sponge (14.0 vs. 18.2%, p = 0.6). There was a significant decrease in the attack rate from 18.2 to 5.3% with use of the hourly prophylactic topical steroids (p = 0.012). After introduction of a new trademark of the drape, the incidence of DLK was further reduced from 5.3 to 0.7% (p = 0.016). Conclusion: The cause in a particular DLK epidemic should be identified and eliminated adopting a scientific approach. Hourly steroid use for prophylaxis is recommended until the etiologic agent responsible has been identified.
- Subjects :
- Adult
Male
medicine.medical_specialty
Corneal Stroma
Prednisolone
Keratomileusis, Laser In Situ
Dexamethasone
Surgical Flaps
Postoperative Complications
Anti-Infective Agents
medicine
Humans
Glucocorticoids
Diffuse lamellar keratitis
Keratitis
business.industry
General Medicine
Middle Aged
medicine.disease
Dermatology
Sensory Systems
Surgery
Ophthalmology
Drug Therapy, Combination
Female
business
medicine.drug
Fluoroquinolones
Subjects
Details
- ISSN :
- 00303755
- Volume :
- 218
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde
- Accession number :
- edsair.doi.dedup.....d545db6d43339974df97596fead8869b