The Effect of Topical Betamethasone Eye Drops on Postoperative Haze among Patients Undergoing Corneal Collagen Cross-Linking: a Randomized, Double Blind Placebo Controlled Study

Objective: To evaluate the effect of topical betamethasone eye drops on postoperative haze among patients undergoing corneal collagen cross-linking (CXL). Patients and Methods: Patients with mild to moderate keratoconus, aged 18 to 30 years, who were a candidate for CXL treatment and had the evidence of disease progression based on topographic findings entered the present study. One eye of each patient randomly received betamethasone and topical antibiotics after CXL and the other eye received topical antibiotics and placebo in place of betamethasone. The eyes were compared regarding BCVA, UCVA, refraction, keratometric and pachymetric findings using Pentacam, as well as changes of corneal haze using confocal microscopy, before CXL as well as one month and six months after CXL. Results: There was no difference in BCVA, UCVA, refraction, keratometric and pachymetric findings between the two groups before and six months after surgery. Based on confocal findings, the difference in light reflectance intensity between the case and control groups was statistically significant in anterior (P = 0.021) and posterior (P = 0.017) corneal stroma one month postoperatively, indicating higher haze in the placebo group. This difference was also statistically significant in anterior (P = 0.001) mid (P = 0.002) and posterior (P = 0.002) stroma six months postoperatively. Conclusion: Betamethasone had no effect on visual acuity, refraction, keratometric and pachymetric findings six months after CXL. It reduced corneal haze in both the first and the sixth months postoperatively.