Topical steroids in the treatment of central and paracentral corneal ulcers.
During an 18-month period a prospective randomised trial was conducted on 40 selected patients with bacterial corneal ulcers. Two groups were compared: one was treated with antibiotic only and the other with antibiotic plus steroid. Complications were similar in the two groups. No delay in healing rate of the ulcers was seen with the use of topical steroid. Two methods of assessing visual improvement are discussed, but it was not possible to demonstrate a difference in visual outcome between the two groups.
There are no good quality randomized trials evaluating the effects of adjunct use of topical corticosteroids in bacterial keratitis. The only randomized trial we identified in the literature suffered from major methodological inadequacies.