Ocular hypertensive and anti-inflammatory responses to different dosages of topical dexamethasone in children: a randomized trial

Clin Exp Ophthalmol. 2005 Jun;33(3):252-8. doi: 10.1111/j.1442-9071.2005.01022.x.

Abstract

Background: The purpose of the present study was to investigate the ocular hypertensive and anti-inflammatory responses to two different dosage schedules of 0.1% topical dexamethasone in a population of Chinese children undergoing strabismus surgery.

Methods: Children undergoing bilateral strabismus surgeries were randomly assigned to receive topical 0.1% dexamethasone eye drops four times daily (group A) or twice daily (group B) for 4 weeks. Intraocular pressure (IOP) and anti-inflammatory responses were monitored for 8 weeks.

Results: A total of 137 children with mean age 6.5 years (SD, 1.9 years; range, 3-10 years) participated in the study. The IOP increased significantly after 4 weeks in both groups compared to the preoperative values (P < 0.001). Peak IOP ranged from 14.0 to 50.3 mmHg in group A and 11.0-41.3 mmHg in group B. Cases in group A (mean, 13.8 mmHg; SD, 8.4 mmHg) had a greater net increase in IOP than cases in group B (mean, 10.2 mmHg; SD, 6.2 mmHg; P = 0.004). Younger-aged children had higher peak IOP (r = -0.244, P = 0.048), and attained the peak IOP earlier (r = 0.252, P = 0.041) in group A. There was no significant difference in ocular inflammatory response between the two groups.

Conclusion: Ocular hypertensive effect to topical 0.1% dexamethasone is dose and age dependent in children. Twice-daily 0.1% topical dexamethasone eye drops control inflammation after strabismus surgery as effectively as four-times-daily dosage, but induces less increase in IOP, and may be a better treatment schedule.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Asian People / ethnology
  • Child
  • Child, Preschool
  • Conjunctivitis / ethnology
  • Conjunctivitis / prevention & control*
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Dose-Response Relationship, Drug
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Hong Kong / epidemiology
  • Humans
  • Intraocular Pressure / drug effects*
  • Male
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / ethnology
  • Postoperative Complications / prevention & control
  • Strabismus / ethnology
  • Strabismus / surgery
  • Tonometry, Ocular

Substances

  • Glucocorticoids
  • Dexamethasone