Steroid treatment of myopic regression: acute refractive and topographic changes in excimer photorefractive keratectomy patients.

We documented acute changes in corneal topography and refraction after readministration of topical steroids in five patients with myopic regression after photorefractive keratectomy (PRK). One was a high myope (-10.00 sphere); the others were moderate myopes (preoperative spherical equivalents -4.25 to -6). All patients had been off steroids for 3 to 8 months before reinstitution. The changes in refractive spherical equivalents ranged from +0.75 to +3.00 diopters, and were observed from 6 days to 4 weeks later. Refractive hyperopic shifts were accompanied by pronounced corneal flattening as measured by computer-assisted corneal topographic analysis. Two to seven months later, three patients have become even less myopic, and two patients have again become slightly more myopic. Topical steroid use can modulate refractive changes after excimer laser treatments in some patients.