To evaluate the clinical effects of early topical steroid treatment on corneal epithelium healing and postoperative corneal haziness after trans-epithelial photorefractive keratectomy (Trans PRK).

A total of 400 eyes from 200 patients who received Trans PRK with the Schwind Amaris laser platform (SCHWIND eye-tech solutions, Kleinostheim, Germany) were included in the present study. In 200 eyes (100 patients, early treated group) topical steroid was used from operation day but in the other 200 eyes (100 patients, late treated group) topical steroid was not used until therapeutic contact lenses were removed. The epithelial healing time, corneal haziness and visual acuity at postoperative 3, and 6 months were compared between the 2 groups.

The therapeutic contact lenses could be removed at postoperative 3.50 ± 1.46 days and 3.14 ± 0.50 days in the early treated group and late treated group, respectively ( p < 0.01). Breakdown of the epithelium after removal of therapeutic contact lenses occurred in 8 eyes, which were all in the early treated group. The difference of the visual acuity at postoperative 3 and 6 months between the 2 groups was not statistically significant. However, at postoperative 6 months, the corneal opacity developed in 12 eyes (6%) in the late treated group and 2 eyes (1%) in the early treated group ( p = 0.01).

Early treatment with topical steroid can delay corneal epithelial healing, especially the attachment of epithelium to stroma. However, the treatment can reduce the prevalence of corneal opacity after Trans PRK.