Comparison of Safety and Efficacy of Prednisolone Acetate Vs Difluprednate Vs Loteprednol Eye drops Post Cataract Surgery (original) (raw)
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Journal of Clinical & Experimental Ophthalmology, 2011
conducted at a single center, private, teaching, multi-specialty practice in Las Vegas, Nevada. The study began on 3 May 2010 and ended on 17 September 2010. There were a total of 137 eyes (patients) enrolled with 111completing the study. Medications were provided for all the patients throughout the study period and none of the patients in study incurred any cost relating to medications in the post-operative period. Patient selection and treatment group Patients with visually significant cataract that have consented to cataract surgery were informed of the study. Consenting subjects were enrolled and randomized into three groups: Control (steroid-[Gatifloxacin 0.3% {Allergan Inc.
US Ophthalmic Review, 2011
Purpose:To determine whether bromfenac as a single agent is just as safe and effective as a corticosteroid in post-operative cataract surgery.Methods:Retrospective chart review compared over 400 eyes undergoing cataract surgery. Two hundred eyes were analyzed in each group. The first group received topical Pred Forte® 1 % (prednisolone acetate 1 %, Allergan) four times daily for two weeks, then tapered over the following three weeks, and the second group had topical Bromday™ (bromfenac 0.09 %, ISTA) as a single agent once daily, two days before surgery and for four weeks after. Outcomes measured were best corrected visual acuity (BCVA), post-operative pain, inflammation, cystoid macular edema (CME), and raised intraocular pressure (IOP).Results:Both groups had excellent vision improvement, to 20/27.2 (Pred Forte group) and 20/26.6 (Bromday group) average BCVA at one month post-operation. Both groups had excellent pain and inflammatory control at the one-day, two-week, and one-month ...
European Ophthalmic Review, 2012
Ocular inflammation and pain are a common consequence of cataract surgery, and if left untreated, may lead to extensive ocular damage, resulting in impaired vision as well as decreased satisfaction with the procedure. Effective management of ophthalmic inflammation after surgery is therefore vital. Topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) have become a mainstay of management of ocular pain and inflammation as a result of their anti-inflammatory activity, analgesic property and established safety record. Numerous studies have demonstrated the efficacy of topical NSAIDs in post-operative prevention of ocular inflammation, inhibition of intra-operative miosis, reduction of pain associated with cataract surgery and pre-operative use to prevent cystoid macular oedema. Studies have also indicated that NSAIDs and steroids act synergistically when administered together, and that a combination of steroid and NSAID therapy is recommended to achieve successful outcomes. With appropriate administration, NSAIDs are safe and effective therapeutic agents, which rarely result in serious local and systemic responses.
Comparison of Efficacy of Difluprednate 0.05% and Loteprednol Gel 0.5% After Cataract Surgery
Eye & Contact Lens: Science & Clinical Practice, 2017
To compare the outcomes and complications of topical difluprednate 0.05% and loteprednol gel 0.5% after routine cataract surgery. Methods: Subjects received either difluprednate emulsion 0.05% (n¼30 eyes) or loteprednol gel 0.5% (n¼30 eyes) after routine cataract surgery. Topical steroid drops were initiated 3 days before cataract surgery and continued for 2 weeks postoperatively. Anterior chamber (AC) cell grade, corneal edema, corneal pachymetry, visual acuity, ocular surface quality (Oxford scale), and intraocular pressure (IOP) were evaluated at 1 day, 1 week, and 1 month postoperatively. Results: Patients treated with difluprednate or loteprednol had statistically similar resolution of their AC cell grade and corneal edema at 1 day, 1 week, and 1 month postoperatively (P.0.05 at each study visit). Difluprednate-treated and loteprednol-treated eyes achieved a mean bestcorrected visual acuity of at least 20/25 by 1 week postoperatively (0.055 and 0.061 logarithm of the minimum angle of resolution, respectively; P¼0.82). The nasal ocular surface quality at 1 week had improved in loteprednol-treated eyes compared with difluprednate-treated eyes (1.0 vs. 1.9 Oxford score, respectively; P,0.001), but similar at all other visits. There was no statistical difference between IOP levels between both treatment groups (P.0.05). In the difluprednate-treated group, one patient developed rebound inflammation and two patients developed cystoid macular edema at their 1-month postoperative visit. Conclusions: The anti-inflammatory effect, visual recovery, and IOP of patients using topical difluprednate or loteprednol gel after cataract surgery are equivalent. There may be an additional short-term benefit of loteprednol gel in protecting the ocular surface after cataract surgery.
BMJ Open, 2019
ObjectiveTopical steroids are the cornerstone in controlling the inflammation after cataract surgery. Prednisolone acetate and difluprednate are the two main products for this purpose. However, it is unclear which one should be used in terms of effectiveness and safety.DesignSystematic review and meta-analysis.Data sourcesMedline via PubMed, Cochrane Central Register of Controlled Trials, Web of science and clinicaltrials.gov were searched through 10 January 2018, and updated on 20 July 2019, in addition to researching the references’ lists of the relevant articles.Eligibility criteriaRandomised-controlled trials (RCTs) comparing difluprednate and prednisolone acetate regardless of the dosing regimen used.Data extraction and synthesisTwo independent authors assessed the included RCTs regarding the risk of bias using the Cochrane tool. Relevant data were extracted, and meta-analysis was conducted using a random-effects model. The Grading of Recommendations Assessment, Development, an...
Cataract surgery and nonsteroidal antiinflammatory drugs
Journal of Cataract and Refractive Surgery, 2016
Nonsteroidal antiinflammatory drugs (NSAIDs) have become an important adjunctive tool for surgeons performing routine and complicated cataract surgery. These medications have been found to reduce pain, prevent intraoperative miosis, modulate postoperative inflammation, and reduce the incidence of cystoid macular edema (CME). Whether used alone, synergistically with steroids, or for specific high-risk eyes prone to the development of CME, the effectiveness of these medications is compelling. This review describes the potential preoperative, intraoperative, and postoperative uses of NSAIDs, including the potency, indications and treatment paradigms and adverse effects and contraindications. A thorough understanding of these issues will help surgeons maximize the therapeutic benefits of these agents and improve surgical outcomes. Modern cataract and lens surgery is commonly facilitated by the use of topical medications before and after the surgical procedure. These topical medications may include antibiotics, steroids, nonsteroidal antiinflammatory drugs (NSAIDs), and the full array of glaucoma medications to modulate intraocular pressure (IOP) in the perioperative period. Many surgeons have found NSAIDs to be an indispensable tool for providing the best surgical outcomes in both routine and complicated cataract procedures. As a class of drugs, NSAIDs have been proven to be a safe and effective alternative to corticosteroids in the topical prevention and management of noninfectious ocular inflammation and cystoid macular edema (CME). 1,2 They have also been valued as a means of maintaining intraoperative mydriasis and moderating postoperative pain. Whether used alone, synergistically with corticosteroids, or for specific high-risk eyes prone to the development of CME, the effectiveness of these medications is compelling. This paper reviews the literature on currently available topical and intracameral NSAIDs and their various uses in cataract and lens surgery, with specific attention to the prevention and
Tropical Journal of Ophthalmology and Otolaryngology
Introduction: Intraoperative miosis is a problem which can lead to various complications that may adversely affect the outcome of cataract surgery. Topical non-steroidal anti-inflammatory drugs (NSAIDs) have been found to be helpful in reducing the intraoperative miosis. We tried to compare the effectiveness of two such molecules bromfenac and nepafenac. Objective: To compare the effectiveness of topical bromfenac (0.09%) and nepafenac (0.1%) in maintaining mydriasis and controlling immediate post-operative inflammation in cataract surgery. Methods: This is a prospective, randomised, open-label, comparative study of patients with senile cataract posted for cataract extraction and intra-ocular lens (IOL) implantation. The patients were randomised into 3 groups: topical moxifloxacilin 0.5% alone (control group or group A), topical bromfenac 0.09% + moxifloxacilin 0.5% (group B) and topical nepafenac 0.1% + moxifloxacilin 0.5% (group C). The drops were started one day before surgery. Mean pupil diameter was measured before starting surgery and after implanting IOL. Slit lamp examination was done on first postoperative day to look for anterior chamber reaction. The values were compared among the 3 groups. Results: The total loss of mean pupillary diameter was significant (p < 0.0001) in control group (25.87%) as compared to bromfenac (3.51%) and nepafenac (3.81%) group. Post-operative inflammation was significantly less (p <0.0001) in bromfenac and nepafenac group as compared to that of control group. Loss of mydriasis and post-operative inflammation was similar in both bromfenac and nepafenac group. Conclusion: Both bromfenac and nepafenac given topically prior to cataract surgery are equally effective in maintaining mydriasis during surgery as well as in controlling immediate postoperative inflammation.
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Post-operative ocular inflammation is a common occurrence following cataract surgery. Corticosteroids have been used to treat ocular inflammation; however, they carry a risk of side effects, particularly an increase in intra ocular pressure (IOP). Previous studies have proved that difluprednate is more efficacious compared to dexamethasone. Hence this study was undertaken to compare the efficacy of difluprednate ophthalmic emulsion 0.05% and dexamethasone 0.1% in postoperative management after small incision cataract surgery. Materials and Methods: A total 200 patients were selected as per inclusion criteria and equally divided between difluprednate and dexamethasone groups. Dexamethasone 0.1% or difluprednate0.05% was prescribed post operatively following small incision cataract surgery. Patients were examined on post-operative day 1, 7, 15 and 30 for anterior segment by slit-lamp examination and side effects. IOP was measured in both the groups on day 30. Results: In our observation both drugs were efficient in the reduction of anterior chamber cells and flare with difluprednate being more rapid. Corneal edema was reduced equally by both the drugs at all observation periods. There was no clinically significant IOP elevation in both difluprednate and dexamethsone group. Difluprednate was found to be more effective in controlling pain compared to dexamethasone. Conclusion: As per present study both difluprednate ophthalmic emulsion 0.05% eye drops and dexamethasone 0.1% eye drops were equally effective in reducing post cataract surgery inflammation. Hence, difluprednate emulsion 0.05% can be used in postoperative management after cataract surgery; nonetheless, further clinical trials with long follow- up period are required. Keywords: Cataract surgery, Dexamethasone, Difluprednate, Dose uniformity, Ocular inflammation, Opthalmic emulsion.