***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate the safety and effectiveness of loteprednol etabonate 0.5 % ophthalmic suspension in reducing the ocular signs and symptoms accompanying contact lens-associated giant papillary conjunctivitis . METHODS In a r and omized , double-masked , placebo-controlled , parallel-group study conducted at 14 academic or private practice clinics , 223 adults with contact lens-associated giant papillary conjunctivitis received either loteprednol or the loteprednol vehicle ( placebo ) , one drop , four times daily for 6 weeks . Papillae , itching , contact lens intolerance , other signs and symptoms of giant papillary conjunctivitis ( O-to-3 or O-to-4 grade scales ) , and intraocular pressure were measured . RESULTS The proportion of patients treated with loteprednol who at final visit demonstrated an improvement in papillae of at least one grade ( 78 % , 85/109 ) was significantly greater than the proportion of those treated with placebo ( 51 % , 56/110 ; P = .001 ) . A treatment difference favoring loteprednol was seen with improvement in itching ( 95 % vs 81 % , 104/109 vs 89/110 ; P < .001 ) and lens intolerance ( 87 % vs 77 % , 95/109 vs 85/110 ; P = .053 ) . Eight of 109 patients ( 7 % , all taking loteprednol ) had an intraocular pressure increase of 10 mm Hg or more on at least one visit during treatment . After discontinuation of loteprednol , intraocular pressure returned to normal levels . Both treatments were well tolerated , and no serious unexpected treatment-related medical events were reported . CONCLUSIONS The rapid therapeutic response combined with the low incidence and transient nature of any intraocular pressure increase suggests that loteprednol is an appropriate treatment for giant papillary conjunctivitis Using non-invasive anterior chamber fluorophotometry , we performed a double-blind , r and omized clinical trial on the effects of dexamethasone 0.1 % and prednisolone acetate 1.0 % eye drops on the blood-aqueous barrier after phacoemulsification and posterior chamber lens implantation . Twenty patients received one of the preparations topically to the surgically treated eye 5 times daily for a period of 5 days , beginning the day after surgery . Patients chosen for the study had no history of eye disease other than senile cataract nor of systemic diseases influencing the eyes . No other steroids or non-steroidal anti-inflammatory drugs were given before or during the investigation . The fluorometric data measured 5 days after surgery show a lower mean concentration of fluorescein in the dexamethasone alcohol 0.1 % treated group compared with the prednisolone acetate 1.0 % treated group . The difference is statistically not significant . The clinical assessment of postoperative ocular inflammation did correlate with the fluorophotometric measurements . The results of the study indicate that although dexamethasone is the more potent anti-inflammatory agent , with a better binding affinity to glucocorticoid receptors , we are — with the number of cases measured — unable to demonstrate any difference in the efficacy in protecting the blood-aqueous barrier after cataract extraction and posterior chamber lens implantation to prednisolone acetate Anterior chamber fluorophotometry was done after the oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction and posterior chamber intraocular lens insertion before and after surgery . The administration of ketorolac solution 0.5 % eye drops before and after surgery decreased the breakdown of the blood-aqueous barrier as much as did dexamethasone sodium phosphate solution 0.1 % ( dexamethasone solution ) eye drops at each postoperative time period as measured by fluorophotometry . Slit-lamp observations of postoperative anterior ocular inflammation were not different between treatment groups . Both ketorolac and dexamethasone solutions were well tolerated by patients . No additional corticosteroids were given to any patients during the study . Therefore , ketorolac solution was as effective as dexamethasone solution in suppressing postoperative inflammation after cataract surgery as measured by fluorophotometry and as observed by slit-lamp examinations . This study confirms prior studies that suggest ketorolac ophthalmic solution 0.5 % may be effective and safe as a nonsteroidal antiinflammatory agent for topical use after cataract surgery and intraocular lens implantation and as a substitute for topically applied corticosteroids PURPOSE To test an aqueous eye drop solution containing a high concentration of dexamethasone  in a cyclodextrin-based drug delivery system . This system increases both drug solubility in aqueous eye drops and drug permeability into the eye , through drug cyclodextrin-polymer co-complexes . METHODS 2-hydroxypropyl-beta-cyclodextrin is a water-soluble oligosaccharide that can be used to dissolve lipophilic drugs , such as dexamethasone , in aqueous solutions . Co-complexation with a polymer further increases the solubility and increases drug permeability through biologic membranes . Eye drops containing dexamethasone ( 0.32 % and 0.67 % ) , 2-hydroxypropyl-beta-cyclodextrin , and polymer  were given to patients before cataract surgery , and the result ant  dexamethasone concentration was measured from aqueous humor sample s. RESULTS The dexamethasone-cyclodextrin drops give a significantly higher concentration of dexamethasone in aqueous humor than dexamethasone alcohol 0.1 % ( Maxidex ) . Heating of the dexamethasone-cyclodextrin-polymer co-complexes appears to enhance the permeability of the drug into the eye . CONCLUSIONS The cyclodextrin-based drug delivery system enhances both the solubility of dexamethasone  in aqueous eye drops and the permeability of the drug into the human eye .  Dexamethasone concentration levels in the human aqueous humor exceed those reported with currently available steroid eye drops PURPOSE Two multicenter studies compared the efficacy and safety of rimexolone 1 % ophthalmic suspension ( Vexol 1 % , Alcon ) and 1 % prednisolone acetate ( Pred Forte , Allergan ) . METHODS Patients with acute uveitis , recurrent iridocyclitis , or chronic uveitis treatable by topical corticosteroid were enrolled . Treatment regimen was one or two drops every hour during Week 1 , every two hours during Week 2 , four times a day during Week 3 , and once a day for the last three days . Efficacy and safety were determined on Days 3 , 4 , 7 to 10 , 14 , 21 , and 28 . A post study evaluation was conducted 36 to 72 hours after treatment was stopped . RESULTS When anterior chamber cell and flare were measured , rimexolone 1 % was found to be as effective as 1 % prednisolone . The largest difference observed between treatments was 0.5 score unit , not clinical ly significant . There were no statistically significant differences in cell scores in either study ( P > .05 ) . No statistically significant differences in flare scores were found except at Day 28 in Study One ( P = .04 ) . Also , prednisolone was found to be more likely than rimexolone to cause a clinical ly significant increase ( 10 mm Hg or more ) in intraocular pressure ( 1.7 times more likely in Study One , eight times more likely in Study Two ) . CONCLUSION Rimexolone 1 % ophthalmic suspension is safe and effective for the treatment of uveitis CONTEXT The use of systemic corticosteroids is a known risk factor for the development of cataracts . OBJECTIVE To determine whether treatment with inhaled corticosteroids is associated with  cataract extraction in the elderly . DESIGN Case-control study . SETTING Quebec universal health insurance program for all elderly ( provincial health insurance plan data base [ RAMQ data base ] ) . PATIENTS RAMQ enrollees 70 years and older . The 3677 cases were patients with a cataract extraction between 1992 and 1994 . The 21868 controls were r and omly selected from patients who did not have a diagnosis of cataract and matched to cases on the index date of the case . MAIN OUTCOME MEASURES Odds ratio of cataract extraction in patients with prolonged cumulative exposure to inhaled corticosteroids  compared with nonusers . RESULTS Excluding patients with systemic steroid treatment and after adjusting for age , sex , diabetes , systemic hypertension , glaucoma , ophthalmic steroids , and the number of physician cl aims for services , use of inhaled corticosteroids for more than 3 years was associated with undergoing cataract extraction ( odds ratio [ OR ] , 3.06 ; 95 % confidence interval [ CI ] , 1.53 - 6.13 ) . For high average daily doses of beclomethasone or budesonide ( > 1 mg ) , the OR was elevated after more than 2 years of treatment ( OR , 3.40 ; 95 % CI , 1.49 - 7.76 ) , whereas for low to medium doses ( < or = 1 mg ) of these drugs , the OR was 1.63 ( 95 % CI , 0.85 - 3.13 ) after 2 years . CONCLUSION Prolonged administration of high doses of inhaled corticosteroids increases the likelihood of undergoing cataract extraction  in elderly patients . Further studies are needed to investigate the risk of developing cataracts for low to medium doses over longer periods Thirty patients with first episode disciform keratitis and with no previous steroid exposure were r and omly assigned to double blind treatment with 3 % acyclovir ointment and 0.1 % betamethasone ( Betnesol ) drops or acyclovir ointment and matching placebo . In the steroid group 14 of the 15 patients healed in a mean time of 21.8 days . In the placebo group eight of the 13 patients healed in a mean time of 34.5 days . The difference in mean healing time between the two groups was significant ( p < 0.05 ) . The cumulative rate of healing was also quicker in the steroid group when compared with the placebo group ( p < 0.001 ) . Other clinical parameters improved more favourably in the combination treatment group . Four patients , two in either group , experienced a mild transient punctate epitheliopathy , but no other serious adverse effects were noted . There has been no significant difference in the recurrence rate between the two groups after a mean follow-up period of approximately 3 years The concentration of steroids in the aqueous humour was measured at various intervals after subconjunctival injection in a series of 130 patients of both sexes who came to cataract extraction . Both hydrocortisone acetate ( 0.5 ml of 2.5 per cent solution ) and dexamethasone sodium phosphate ( 0.5 ml of 0.4 per cent solution ) attained a peak concentration in the aqueous of 214.4 and 268.0 micrograms/ml respectively within 10 minutes . Dexamethasone was from 30 to 47 times more effective than hydrocortisone for up to 24 hrs , but the latter provided a reasonably high concentration for up to 7 days PURPOSE To compare the safety and efficacy of loteprednol etabonate 0.5 % ophthalmic suspension with prednisolone acetate 1.0 % ophthalmic suspension in reducing the  ocular signs and symptoms associated with acute anterior uveitis . METHODS Two prospect i ve studies were conducted in sequence . Both were parallel , r and omized , double-masked , active-controlled comparisons conducted at academic or private practice clinics in the United States .  Efficacy was evaluated by the proportion of patients with a score of 0 for key signs and symptoms of uveitis . Intraocular pressure was increased regularly . The first study involved up to 42 days of treatment , starting with a dose of eight times per day . The second study involved up to 28 days of treatment , starting with a dose of 16 times per day . RESULTS In the first study ( N = 70 ) , the proportion of patients achieving resolution by the final visit was anterior chamber cell ( 74 % loteprednol etabonate , 88 % prednisolone acetate , P = .194 ) and flare ( 71 % loteprednol etabonate , 81 % prednisolone acetate , P = .330 ) . In the second study ( N = 175 ) , the proportion of patients achieving resolution by the final visit was anterior chamber cell ( 72 % loteprednol etabonate , 87 % prednisolone acetate , P = .015 ) and flare ( 66 % loteprednol etabonate , 82 % prednisolone acetate , P = .017 ) . In both studies , intraocular pressure increase of more than 10 mm Hg was observed more frequently in patients receiving  prednisolone acetate  ( seven patients ) than those receiving loteprednol etabonate ( one patient ) . CONCLUSIONS Although a clinical ly meaningful reduction of signs and symptoms was noted in both treatment groups , loteprednol etabonate was less effective than prednisolone ac 
    Output:
    
Dexamethasone alcohol 0.1 % and prednisolone acetate 1 % are potent corticosteroids , but the latter achieves the highest aqueous concentration within 2 h and maintains higher levels for 24 h. Subconjunctival corticosteroids provide very high concentrations in the aqueous which maintain higher concentrations for longer periods