I am wondering if anyone knows the article about using PO steriods for treatment of SOS that was published within the last month? We have a patient who had grade III OU, and we were only able to lift the right eye due to lack of patient
cooperation. The left eye VA is stable at 20/30- and although the center is clearing, the nasal area of the flap is significantly affected. I am wondering if putting the patient on 60 mg x 1 week and tapering over 2 would be an option? I cleared it through the patient's internist, but it was not done. Thanks for any help.

The treatment of DLK (SOS) depends on the grading/severity. At the American Academy of ophthalmology meeting, a number of talks discussed the treatment of DLK. For grade 1 and 2, the recommendations in general were to treat the eye with steroids alone (I did not hear any talks on the use of oral steroids). If the DLK is more severe, then lifting the flap and washing the flap/interface are critical steps for preventing severe damage to the eye/corneal flap.
For patients who are not cooperative, it might not be unreasonable to consider the use of valium pre-surgery to keep the patient relaxed enough for a flap lift, if this is clinically indicated.

I hope this helps

Best of luck

Bill Trattler, MD
Miami, FL