Observational study on the use of anti-inflammatory and IOP-lowering eye drops in patients with refractive regression after corneal laser surgery

This retrospective observational study describes the clinical outcomes and examines the association between refractive regression and corneal epithelial remodeling in patients treated with combined fluorometholone and intraocular pressure (IOP)-lowering eye drops after corneal laser surgery. Patients with refractive regression following corneal laser surgery who were treated with fluorometholone combined with either timolol maleate or brimonidine tartrate were included. Changes in uncorrected visual acuity (UCVA), spherical equivalent (SE), and central corneal epithelial thickness were recorded over time. Statistical analyses, including normality testing with the Shapiro-Wilk test and correlation analysis, were performed to evaluate the relationship between refractive outcomes and epithelial remodeling. Mean UCVA improved from 0.28 ± 0.10 to 0.08 ± 0.08 LogMAR, SE from - 1.49 ± 0.37 days to - 0.77 ± 0.29 days, and epithelial thickness from 68.22 ± 4.40 μm to 59.63 ± 4.99 μm (all P <.001). △ET was positively correlated with improvements in SE (R = 0.742, P <.001) and UCVA (R = 0.446). A linear relationship (y = 0.0559x + 0.1522) suggested that a 15 μm decrease in epithelial thickness corresponded to a 1 day improvement in SE. Patients with refractive regression after corneal laser surgery showed improvements in UCVA and SE, accompanied by reductions in central corneal epithelial thickness. These findings suggest that corneal epithelial remodeling may contribute to refractive outcomes in this setting. However, as this was an observational study without a control group, causality cannot be inferred. Further controlled studies are needed to validate these findings.