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Diclofenac versus fluorometholone after strabismus surgery in children
  1. Hee Kyung Yang1,
  2. Sang Beom Han2,
  3. Jeong-Min Hwang1
  1. 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  2. 2Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, Kangwon
  1. Correspondence to Dr Jeong-Min Hwang, Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; hjm{at}snu.ac.kr

Abstract

Aims To compare the effects of topical diclofenac sodium with those of fluorometholone on intraocular pressure (IOP) and conjunctival inflammation after strabismus surgery.

Methods We retrospectively analysed 60 Korean children who underwent strabismus surgery for intermittent exotropia in an institutional referral centre. Patients received topical diclofenac 0.1% or fluorometholone 0.1% after surgery for up to 4 weeks. IOP, patient discomfort, conjunctival inflammation and conjunctival injection were evaluated at 1, 2, 3 and 4 weeks after surgery.

Results In the fluorometholone group, 23% showed an increase of ≥10 mm Hg compared to the baseline IOP within 4 weeks of surgery. The fluorometholone group showed a significant change in IOP compared to baseline (p<0.001) at all follow-up time points, whereas the diclofenac group showed no significant increase in IOP. An increased risk of IOP elevation of ≥10 mm Hg was observed after fluorometholone use in patients under 7 years of age. There was no significant difference in patient discomfort, conjunctival inflammation or conjunctival injection between the two groups. Conjunctival injection was more pronounced with muscle resection than with recession at 1 month after surgery.

Conclusions Postoperative topical diclofenac is an excellent substitute for steroids, particularly in young children under 7 years of age.

  • Intraocular Pressure
  • Inflammation
  • Conjunctiva
  • Treatment Surgery

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