Effect of Timolol on Refractive Outcomes in Eyes With Myopic Regression After Laser In Situ Keratomileusis: A Prospective Randomized Clinical Trial

We perused with great interest the randomized controlled trial by Shojaei and associates, which studied the effect of timolol eye drops in refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK). In this trial, the authors compared the outcomes of treating patients presenting with myopic regression following LASIK with timolol eye drops instilled twice a day to treatment by instilling artificial tear drops in an identical regime as placebo. The spherical equivalent was significantly better in the timolol (treatment) arm 6 months after treatment, and also 6 months after discontinuation of treatment (P < .001 for both comparisons). Based on these results, the authors concluded that instillation of timolol eye drops is effective for the treatment of myopic regression after LASIK and its effect seems to last for at least 6 months after discontinuation. The study design and statistical analysis were appropriate, but we do have the following observations to make.