It can be speculated that the thinned and flattened central cornea after excimer laser photorefractive keratectomy (PRK) might give a falsely low Goldmann applanation tonometer(GAT) reading. We studied 353 eyes of 264 patients who underwent PRK to determine the effect of excimer laser PRK on the accuracy of Goldmann applanation tonometry. PRK was done with a VISX 20/20 excimer laser and topical fluorometholone was used after PRK. The intraocular pressure(IOP) was measured with the GAT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean ablation depth of the cornea was 71.4 +/- 22.0 micrometer, and the eyes were divided into three groups according to their ablation depths. The mean postoperative IOP measured with the GAT decreased as compared with the mean preoperative IOP(P<0.01). The mean postoperative IOP at 9 or 12 months was lower than that at 1, 3, or 6 months(p<0.05). The mean IOP(11.9 +/- 2.5 mmHg) at 12 months was 2.8 mmHg lower than the mean preoperative IOP(14.7 +/- 2.7 mmHg). There was no statistically significant difference in the amount of postoperative IOP decrease among the three groups.
Cornea ; Fluorometholone ; Humans ; Lasers, Excimer* ; Manometry* ; Photorefractive Keratectomy*

The authors' clinical experience has suggested that the noncontact tonometer (NCT) has a tendency to record a lower intraocular pressure(IOP) than the Goldmann applanation tonometer(GAT) after excimer laser photo refractive keratectomy(PRK). This study was done to verify this tendency. We performed PRK on 177 eyes of 122 patients using a VISX 20/20 excimer laser, and topical fluorometholone was used after PRK. The eyes were divided into three groups according to their ablation depths, and the IOP was measured with the GAT and the Topcon NCT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean postoperative IOP measured with the GAT or the NCT decreased as compared with the mean preoperative IOP(GAT: 1.67 ~ 2.90 mmHg, NCT:5.27 ~ 6.54 mmHg). The mean NCT reading was 1.12 mmHg higher than the mean GAT reading preoperatively, but was 2.48 ~ 2.88 mmHg lower than the mean GAT reading postoperatively. Difference between GAT and NCT measurements postoperatively was more prominent in the group of deeper ablation. These results suggest that we should be cautious of evaluating the IOP measured with the GAT or the NCT after PRK.
Fluorometholone ; Humans ; Intraocular Pressure ; Lasers, Excimer* ; Photorefractive Keratectomy*

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

To evaluate the corneal epithelial barrier after exposure to Benzalkonium chloride(BAC) or commonly used eyedrops, we measured corneal uptake of 5, 6-carboxyfluorescein(CF) applied to the corneal epithelium of the albino rabbits(70 eyes). Four BAC solutions (0.001 %, 0.01%, 0.05%, 0.1 %), ofloxacin solutions (Tarivid(R), Octacin(R), Ofloxacin(R)), fluorometholone solutions(Fumelon(R), Fluorometholone(R)), artificial tear solutions (Tears Naturale(R), Tears Naturale II(R), Tears naturale Free(R)) were evaluated. Balanced salt solution was used in control group. As the concentration of BAC increased, corneal epithelial permeability increased. In Octacin(R) group, corneal epithelial permeability increased about 5 times more than in Tarivid(R) and Ofloxacin(R) groups (p<0.01). Fluorometholone(R) group showed less increased permeability than in Fumelon group, but there was no statistical difference between them(p>0.05). Tears Naturale(R) showed the highest permeability among artificial tear solutions and there were no statistical differences between Tears Naturale II(R), Tears Naturale Free(R) and control group(p>0.1). This study showed that the higher concentration of BAC, the more damages to the barrier function of the corneal epithelium, and that clincally used eyedrops containing BAC made destructive influences on the corneal epithelial integrity.
Benzalkonium Compounds* ; Epithelium, Corneal ; Fluorometholone ; Ofloxacin ; Ophthalmic Solutions* ; Permeability ; Tears

PURPOSE: We compared therapeutic efficacy and steroid-induced IOP elevation of 1% rimexolone with that of 0.1% fluorometholone. METHODS: Of all LASIK treated eyes from March of 2001 to December of 2002 in Sungae General Hospital, 46 eyes were treated with 1% rimexolone and 46 eyes were treated with 0.1% fluorometholone. And we measured the degree of myopic regression (1 day, 1 month, 3 month) and intraocular pressure (1 month). RESULTS: Statistically signicant difference in therapeutic efficacy of myopic regression, and no statistically signicant difference in IOP were found. The therapeutic efficacy of 1% rimexolone was higher. CONCLUSIONS: We concluded that application of 1% rimexolone was more useful in myopic regression following LASIK rather than that of 0.1% fluorometholone.
Fluorometholone* ; Hospitals, General ; Intraocular Pressure ; Keratomileusis, Laser In Situ*

PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.
Abdomen ; Axilla ; Extremities ; Eyelids* ; Fluorometholone ; Humans ; Perineum ; Scrub Typhus* ; Vasculitis

PURPOSE: To determine the effectiveness of the method for preventing corneal opacity and minimizing the intraocular pressure (IOP) increase after photorefractive keratectomy treated with 0.1% fluorometholone and tranilast (0.5% tranilast, Krix®, JW pharmaceutical, Seoul, Korea), especially in cases with elevated IOP. METHODS: The patients who underwent photorefractive keratectomy from May 2014 to May 2015 were enrolled in the present study. The data of 49 patients (49 eyes) with elevated IOP at 1 month postoperatively and who used 0.1% fluorometholone and tranilast eye drops (tranilast group) were analyzed and compared with the control group consisting of patients who underwent the same surgery from December 2012 to October 2013 but used only 0.1% fluorometholone. RESULTS: The visual acuity at postoperative 6 months was log MAR -0.08 ± 0.05 and log MAR -0.08 ± 0.04 in the tranilast group and control group, respectively. The eye drops were used postoperatively for 17.7 ± 3.3 weeks in the tranilast group and for 20.5 ± 3.7 weeks in the control group (p < 0.01). Anti-glaucoma eye drops were used for 18.4 ± 3.2 weeks and 20.9 ± 3.7 weeks postoperatively in the tranilast group and control group, respectively (p < 0.01). CONCLUSIONS: Adding tranilast eye drops to patients whose IOP was elevated because of 0.1% fluorometholone use after photorefractive keratectomy is an effective method for preventing corneal haze and minimizing IOP elevation.
Corneal Opacity ; Fluorometholone* ; Humans ; Intraocular Pressure ; Ophthalmic Solutions* ; Photorefractive Keratectomy* ; Seoul ; Visual Acuity

Intraocular pressures (IOP)were measured following Neodymium (Nd): YAG laser posterior capsulotomy in 51 pseudophakic eyes which had been treated with phacoemulsification and intraocular lens in the bag.Group 1 was no medical treated, group 2 was treated with 0.5%apraclonidine preoperatively, group 3 was treated with fluorometholone postoperatively, and group 4 was treated with 0.5%apraclonidine preoperatively and with fluorometholone postoperatively.IOP was measured preoperatively and 1, 3, 24 hours and 1 week postoperatively.Four eyes (7.8%)had greater than 5 mmHg elevation of IOP (1 eye in group 1, 3 eyes in group 3)and all of them decreased IOP to normal level within 3 hours.In summary, there was no or little IOP elevation without any medical treatment in eyes which had been treated with phacoemulsification and intraocular lens in the bag and had intact posterior lens capsule.
Cataract* ; Fluorometholone ; Intraocular Pressure* ; Lasers, Solid-State* ; Lenses, Intraocular ; Neodymium ; Phacoemulsification ; Posterior Capsulotomy*

We wanted to evaluate the effects of topical nonsteroidal antiinflammatory drugs (NSAIDs) on refractive outcome and corneal haze after PRK(photorefractive keratectomy) according to the degree of myopia, and compare their effect with those of topical steroids. We divided our patients into moderate myopes (< OR = -6.0D) and high myopes (> OR = -6.0D), and each patient was randomly allocated to one of three drugs for initial management: 0.1% fluorometholone, 0.03% flurbiprofen, 0.1% diclofenac for 4 months after PRK. In moderate myopes, steroid group and NSAIDs group showed no difference in refraction after 6 months, and the subjective haze grading was consistently lower in steroid group after 3 weeks. In high myopes, steroid group and NSAIDs group showed no difference in both refraction and corneal haze after 6 months. Steroid group showed severe myopic regression or corneal haze less frequently than NSAID groups in high myopes. Topical NSAIDs are assumed to be less effective than topical steroids in reducing myopic regression and haze especially in high myopes after PRK.
Anti-Inflammatory Agents, Non-Steroidal ; Diclofenac ; Fluorometholone ; Flurbiprofen ; Humans ; Lasers, Excimer* ; Myopia ; Photorefractive Keratectomy* ; Steroids

PURPOSE: To analyze the time and incidence of increased intraocular pressure (IOP) induced by 0.1% fluorometholone used to prevent corneal haze after photorefractive keratectomy (PRK). METHODS: The present study included 826 patients (826 eyes) who underwent PRK between November 2012 and October 2013 and were followed up for more than 6 months. After surgery the patients were treated with 0.1% fluorometholone for 3-6 months according to their corneal conditions. The time and incidence was analyzed with the time and incidence when anti-glaucoma eye drops were used. RESULTS: Anti-glaucoma eye drops were used in 312 eyes (38%). The anti-glaucoma eye drops were started before 4 weeks postoperatively in 105 eyes (13%) and postoperatively at 5-8 weeks in 86 eyes (10%), at 9-12 weeks in 83 eyes (10%), at 13-16 weeks in 25 eyes (3%) and after 17 weeks in 13 eyes (2%). CONCLUSIONS: The overall incidence of increased IOP when treated with 0.1% fluorometholone for 3-6 months after PRK was approximately 38%. The incidence of increased IOP in each month for the first 3 months was almost identical implying that the longer 0.1 fluorometholone was used, the higher incidence of increased IOP occurred. These results can be helpful in educating patients regarding the risk of increased IOP and determining the follow-up period after PRK.
Fluorometholone* ; Follow-Up Studies ; Humans ; Incidence* ; Intraocular Pressure* ; Keratectomy, Subepithelial, Laser-Assisted ; Ophthalmic Solutions ; Photorefractive Keratectomy*