Document Detail


Survey of steroid usage patterns during and after low-risk penetrating keratoplasty.
MedLine Citation:
PMID:  19654531     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate corneal surgeons' corticosteroid use to prevent rejection of routine first-time penetrating keratoplasty (PKP). METHODS: Between March 2006 and June 2008, corneal surgeons taking an endothelial keratoplasty course at Price Vision Group, a tertiary referral center in Indianapolis, Indiana, were surveyed about steroid usage patterns. RESULTS: Of 271 attendees, 250 (92%) returned a survey. Regardless of lens status, 76% used intraoperative steroids. Dexamethasone was preferred by 72% of those who used injectable steroids. Everyone prescribed topical steroids, and 95% prescribed prednisolone acetate 1%. Most (57%) used the same regimen regardless of lens status. For phakic patients, median daily dosing was 4x for 2 months, 3x for month 3, 2x for month 4, and 1x until 1 year. For pseudophakic/aphakic patients, median daily dosing was the same, except 2x extended through month 5 and 1x continued beyond a year. Topical steroids were continued indefinitely by 46% in pseudophakic/aphakic patients and by 22% in phakic patients. Lower-strength steroids were used for taper by 20% in phakic patients and 16% in pseudophakic/aphakic patients. CONCLUSIONS: While the range of topical steroid dosing after initial PKP was wide, the narrow interquartile range reflected commonly held opinions. The study results can provide a baseline for prospective studies of medications and dosing to prevent PKP rejection.
Authors:
Francis W Price; David A Price; Vanessa Ngakeng; Marianne O Price
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cornea     Volume:  28     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-25     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  865-70     Citation Subset:  IM    
Affiliation:
Price Vision Group, Indianapolis, Indiana, USA. mprice@cornea.org
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Administration, Topical
Adrenal Cortex Hormones / administration & dosage,  therapeutic use*
Aphakia / complications
Corneal Diseases / complications,  surgery
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Prescriptions / statistics & numerical data
Drug Utilization
Graft Rejection / prevention & control*
Health Care Surveys
Humans
Immunosuppressive Agents / administration & dosage,  therapeutic use*
Injections
Intraoperative Period
Keratoplasty, Penetrating*
Postoperative Period
Pseudophakia / complications
Risk Assessment
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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