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Topical steroids and alkali burns
  1. GORDON N DUTTON
  1. West Glasgow Hospitals University NHS Trust, Western Infirmary, Glasgow G11 6NT
    1. ALISON DAVIS
    1. Eye Department, King’s College Hospital, Denmark Hill, London SE5 9RS

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      Editor,—In their recent report attesting to the safety of topical prednisolone in the treatment of alkali burns1 Davis and colleagues do not specify the type of prednisolone which was prescribed. Prednisolone acetate (Pred Forte) is absorbed into the human eye and reaches aqueous concentrations many fold higher than prednisolone phosphate (Predsol)2 perhaps on account of an acetylating enzyme in the cornea.

      It is therefore important to know which form of prednisolone was employed in this study.

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      Editor,—In answer to Mr Dutton’s question, I have rechecked our data and the paragraph detailing treatment should now read:

      “All patients with a grade 1 injury or greater were treated with a standard regimen which included … topical steroid (dexamethasone alcohol 0.1% or prednisolone sodium phosphate 0.5%, or betamethasone sodium phosphate 0.1%; in addition two patients had betamethasone sodium phosphate ointment at night)”

      Of those who had prednisolone drops, none had prednisolone forte eye drops. The aim of our paper was to emphasise the safety of topical steroids when used in conjunction with vitamin C in the treatment of alkali burns. To compare the use of different types of steroids would require a prospective study.

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