Dexamethasone (Sterodex) Versus Loteprendol (Lotemax) Eye Drops Following Strabismus Surgery

Study Overview
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Brief Summary
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The purpose of this study is to compare the efficacy and side effects of topical Loteprendol etabonate 0.5% (Lotemax) versus Dexamethasone 0.1% (Sterodex) following strabismus surgery.

Detailed Description
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This is a randomized prospective study that will involve 100 patients (males and females) undergoing strabismus surgery. All patients will be randomly assigned to receive one of the study drugs (Loteprendol etabonate 0.5% (Lotemax) drops or Dexamethasone 0.1% (Sterodex) drops) after undergoing strabismus surgery. In addition to the study drug all patients (in both groups) will receive topical Ofloxacin 0.3% (Oflox) eye drops. All patients will undergo a complete ophthalmological evaluation before surgery including orthoptic assessment of their strabismus and measurement of intraocular pressure (IOP). Topical treatment with the study drug and topical Ofloxacin 0.3% (Oflox) eye drops will begin on the evening of the surgery, following a schedule that will be the same for both groups: 4 times daily during the first week, 3 times daily for the second group, twice daily for the third week, and as needed for the fourth week. All patients will be examined at 1 day, 1 week, 2 weeks and 4 weeks after surgery by a masked investigator (not the strabismus surgeon). The parameters to be checked will include: Patient pain and discomfort Conjunctival chemosis Conjunctival hyperaemia Conjunctival discharge Conjunctival gap Intraocular pressure (IOP) Number of pain control medications taken

Conditions
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Ophthalmology

Intervention / Treatment
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* Drug: Loteprendol etabonate 0.5%
* Drug: Dexamethasone 0.1%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing recession strabismus surgery through a fornix approach of one of the horizontal recti muscles (either medial rectus or lateral rectus) or of the inferior oblique muscle Must be able to comply with topical treatment Must be able to comply with post-operative appointment schedule. Exclusion criteria: Previous ocular surgery (including previous strabismus surgery) Ocular pathology Family history of glaucoma Personal history of allergic drug reaction or allergic conjunctivitis More than one muscle operated on Adjustable sutures technique Patients in whom it is impossible to measure IOP before surgery

Ages Eligible for Study
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Minimum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Loteprendol<br>Topical Loteprendol used after strabismus surgery | Drug: Loteprendol etabonate 0.5%<br>* Steroid eye drops used after strabismus surgery.<br>|
| Experimental: Dexamethasone<br>Topical Dexamethasone used after strabismus surgery | Drug: Dexamethasone 0.1%<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline - Intraocular pressure (IOP) | IOP will be measured by Goldmann applantation tonometry one day before surgery (baseline IOP). In patients in whom Goldmann tonometry is impossible, ICARE tonometer will be used instead. IOP will be measured 1 day, 1 week, 2 weeks, 4 weeks after surgery, at each time point change from baseline IOP will be recorded. | 1 day before surgery (basline), and 1 day, 1 week, 2 weeks, 4 weeks after surgery | 
| Change from baseline - Conjunctival hyperemia | Conjunctival hyepremia will be measured one day before surgery (basline measurement) using the following scale: 0=no hyperemia, 1=mild (less than one quadrant), 2=moderate (less than half of the conjunctival surface), 3= severe (less than half of the conjunctival surface). Conjunctival hyperemia will be measured 1 day, 1 week, 2 weeks, 4 weeks after surgery, at each time point change from baseline measurement will be recorded. | 1 day before surgery (basline), and 1 day, 1 week, 2 weeks, 4 weeks after surgery |