Topical Softacort following lacrimal surgery: is it safer and as efficacious as conventional steroids?
Author: Kiana Bamdad
Base Hospital / Institution: University Hospital Coventry and Warwickshire
ePoster presentation
Abstract ID: 24-402
Purpose
Postoperative treatments following Dacryocystorhinostomy (DCR) vary. Typically, topical steroid eyedrops are used postoperatively to reduce scarring risk and ensure a successful outcome. In our service, patients undergoing DCR were given a tapering 10-week course of Maxitrol eyedrops (Neomycin-Polymyxin B-Dexamethasone). In January 2020, we changed to Softacort (hydrocortisone sodium phosphate 3.35mg/ml) drops using the same regimen, as the lack of intraocular penetration would reduce risks linked with topical steroids like raised intraocular pressure (IOP), whilst offering the same benefits. We looked at the safety and efficacy of Softacort, as an alternative to conventional steroid drops in patients undergoing DCR.
Methods
Retrospective continuous comparative case note review, looking at all patients who had external/endonasal DCR, at the University Hospital Coventry. Patients treated with Softacort postoperatively, between January 2020 to February 2024 were compared with those treated with Maxitrol postoperatively between January 2019 and January 2020. Postoperative IOP, success of surgery and any complications were included in the outcome measures.
Results
79 patients underwent external DCR; 0/56 patients using Softacort had raised IOP at any point postoperatively. However, 3/23 (13%, p-value: 0.006) patients using Maxitrol experienced a temporary IOP spike which resolved once the steroid drop was discontinued. 42 patients had endonasal DCR; 0/14 patients using Maxitrol had raised IOP, whilst 1/28 (3.6%, p-value: 0.47) using Softacort had a small increase in IOP to 22mmHg which resolved on cessation of treatment. Both groups had similar surgical success rates with no significant difference (p-value: 0.51) between the Softacort and Maxitrol groups.
Conclusion
Our study suggests that Softacort eyedrops provide a safe and effective alternative to conventional steroid drops in this group of patients. The lack of intraocular penetration reduces the risks of raised IOP whilst offering an equivalent anti-inflammatory and cicatricial response.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Emma | Samia-Aly | University Hospital Coventry and Warwickshire |
| Harpreet | Ahluwalia | University Hospital Coventry and Warwickshire |
