Comparison of 0.1% dexamethasone phosphate eye gel (Dexagel) and 1% prednisolone acetate eye suspension in the treatment of post-operative inflammation after cataract surgery

Objectives: To determine the efficacy of topical nepafenac 0.1% eye dropsas compared toprednisolone acetate 1% eye drops in the management of postoperativeinflammation after cataract surgery. Study Design: Randomized controlled clinical study.Place and Duration of study: Pakistan air force hospital Rafiqui from Oct 2016 to Feb 2017.Patients and methods: Two hundred and forty eight eyes were randomly divided in two equalgroups. Patients received nepafenac 0.1% or prednisolone acetate 1% as single drop 8 hourlybeginning 1 day preoperatively, continued till 2 weeks post-operatively. Efficacy of the drugwill be considered if there is no anterior chamber reaction along with no aqueous flare after 2weeks of treatment. Results: 85.5% of cases resolved with topical nepafenac 0.1%as comparedto 88.7% that were cured with prednisolone acetate 1%. Pearson chi square test indicates thatthere is no statistical significant difference (p= 0.449) between the efficacy of two modes oftreatment. Conclusion: Nepafenac 0.1% eye drops are as effective as prednisolone acetate 1%in the prevention of postoperative inflammation with cataract surgery.

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A study on effect of pre-operative topical prednisolone acetate, nepafenac and placebo, on intraoperative mydriasis and its sustenance during cataract surgery: a randomized trial

International Journal of Basic & Clinical Pharmacology ◽

10.5455/2319-2003.ijbcp20150217 ◽

2015 ◽

Vol 4 (1) ◽

pp. 98 ◽

Cited By ~ 2

Author(s):

Saanchal Sethi ◽

Dharamvir Chalia ◽

Mayur Chalia ◽

Maninder Kaur

Keyword(s):

Cataract Surgery ◽

Randomized Trial ◽

Prednisolone Acetate

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Difluprednate versus Prednisolone Acetate after Cataract Surgery: a Systematic Review and Meta-Analysis

BMJ Open ◽

10.1136/bmjopen-2018-026752 ◽

2019 ◽

Vol 9 (11) ◽

pp. e026752

Author(s):

Mahmoud Tawfik KhalafAllah ◽

Ahmed Basiony ◽

Ahmed Salama

Keyword(s):

Systematic Review ◽

Cataract Surgery ◽

Meta Analysis ◽

Prednisolone Acetate ◽

Controlled Trials ◽

Topical Steroids ◽

Cochrane Central Register ◽

Small Incision Cataract Surgery ◽

Significant Difference ◽

Evidence Quality

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, and Evaluation approach was used to appraise the evidence quality.ResultsWe included six RCTs with 883 patients: 441 received difluprednate and 442 received prednisolone acetate. The evidence quality was graded as moderate for corneal oedema and intraocular pressure and low for anterior chamber (AC) clearance. After small incision cataract surgery, difluprednate was superior in clearing AC cells at 1 week (OR=2.5, p>0.00001) and at 2 weeks (OR=2.5, p=0.04), as well as clearing the AC flare at 2 weeks (OR=6.7, p=0.04). After phacoemulsification, difluprednate was superior in terms of corneal clarity at 1 day (OR=2.6, p=0.02) and 1 week after surgery (OR=1.96, p=0.0007). No statistically significant difference was detected between both agents at 1 month in effectiveness. Also, both agents were safe, evaluated by the ocular hypertension (OR=1.23, p=0.8).ConclusionWith low-to-moderate certainty, difluprednate and prednisolone acetate are safe agents for controlling the inflammation after cataract surgery. Difluprednate showed significant superiority in terms of AC cells and AC flare at 2 weeks postoperatively.

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