Preservative-Free Low-Dose Dexamethasone for the Treatment of Chronic Ocular Surface Disease Refractory to Standard Therapy

PURPOSE: To evaluate the short-term safety and efficacy of topical preservative-free dexamethasone 0.01% for the treatment of ocular surface disease and/or tearing refractory to conventional treatments. METHODS: Retrospective chart review of all patients who received topical unpreserved dexamethasone 0.01% (Leiters Pharmacy, San Jose, CA). Follow-up visits were reviewed for subjective responses to the formulation and intraocular pressure. Responses were graded as significant/complete resolution of symptoms (50%-100% improvement), mild (25%-50% improvement), or no improvement. RESULTS: Thirty-one patients received topical unpreserved dexamethasone 0.01% for the treatment of ocular surface disease. Follow up ranged from 4 to 60 months (average, 11.5 weeks). Twenty patients (65%) reported moderate or complete resolution of ocular symptoms. Seven patients (22%) had mild improvement in their symptoms. Four patients (13%) had no change in ocular symptoms. No patient in our series developed an elevation of intraocular pressure greater than 5 mm Hg above baseline intraocular pressure. No patient developed intraocular pressure greater than 22 mm Hg. CONCLUSIONS: Topical nonpreserved 0.01% dexamethasone could be an effective therapy for recalcitrant chronic ocular surface disease.