Randomized prospective study of the influence of steroids on postoperative eye-opening after exploration of the orbital floor

Objective: To find out if giving steroids reduces postoperative swelling in orbital surgery.Design : Prospective, randomized, double blind trial. Setting: Regional unit, teaching hospital, UK. Subjects and interventions: 20 patients who require orbital floor exploration after injuries. Patients were given methylprednisolone 250 mg (or placebo identically packaged) at induction of anaesthesia, with a further three doses at 6-hourly intervals postoperatively. Main outcome measure: Differences in interpalpebral width before and after operation. Results: Those given steroids (n =11) had a significantly increased interpalpebral width compared with placebo (n =9) postoperatively (P< 0.01, 95% confidence intervals of the DIFFERENCE = 1 mm–6 mm). Conclusion: Short courses of steroids therapy should be considered in orbital surgery for appropriate patients. There is an advantage in being able to assess the globe postoperatively.