COMPARISON OF NEPAFENAC PLUS STEROID VERSUS STEROID ALONE FOR CONTROL OF OCULAR INFLAMMATION AFTER PHACOEMULSIFICATION

Main Article Content

Dr Manpreet kour
Dr. Nancy Sharma
Dr Malvika Sharma

Keywords

Nepafenac, Prednisolone, Iritis, Phacoemulsification

Abstract

Introduction: Cataract is the most common surgical procedure. Study was done to compare the effect of nepafenac 0.1% plus prednisolone 1% vs prednisolone 1% alone in controlling ocular inflammation after phacoemulsification


Material and Methods: A total of 140 patients were randomized to receive prednisolone 1% (group I) vs nepafenac plus prednisolone 1% (group II) after uneventful phacoemulsification. Patients were examined on first day, one week and one month for vision, slit lamp evaluation for anterior segment inflammation and cystoid macular edema.


Results: Average visual acuity was 6/9 in both groups. Anterior segment inflammation was significantly less in group II on first post operative day. On later visits, there was no significant difference in inflammation in both groups. CME was not seen in any group.


Conclusion: This study suggests that addition of nepafenac 0.1% to prednisolone 1% significantly reduces the intraocular inflammation after phacoemulsification in the early postoperative period.

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References

1. Thompson J, Lakhani N. Cataracts. Prim Care. 2015;42:409-23
2. McGhee CN, Dean S, Danesh-Meyer H, Locally administered ocular corticosteroids: benefits and risks, Drug Saf 2002;25:33-35.
3. J. Polansky, and R. Weinreb. Steroids as anti inflammatory agent. In M. Sears (ed.), Pharmacology of the Eye, Springer, New York, 1984, pp. 460–583.
4. El-Harazi SM, Feldman RM. Control of intra-ocular inflammation associated with cataract surgery. Curr Opin Ophthalmol. 2001;12:4-8.
5. Harry J., Mission G. Clinical Ophthalmic Pathology, Principles of Diseases of the Eye and Associated Structures. Oxford, UK: Butterworth Heinemann; 2001
6. Ku EC, Signor C, Eakins KE. Anti-inflammatory agents and inhibition of ocular prostaglandin synthetase. Adv Prostaglandin Tromboxane Leukotriene Resp 1976;2:819-23.
7. Ahuja M, Dhake AS, Sharma SK, Majumdar DK. Topical ocular delivery of NSAIDs. AAPS J. 2008; 10:229–241.
8. M. Raizman. Corticosteroid therapy of eye diseases; f ifty years later. Arch. Ophthalmol 1996; 114:1000 1001.
9. Schalnus R. Topical nonsteroidal anti-inflammatory therapy ophthalmology. Ophthalmologica. 2003;217:89–98.
10. Lane SS, Modi SS, Lehmann RP, Holland EJ. Nepafenac ophthalmic suspension 0.1% for the prevention and treatment of ocular inflammation associated with cataract surgery. J Cataract Refract Surg. 2007;33:53-8.
11. Miyanaga M, Miyai T, Nejima R, Maruyama Y, Miyata K, Kato S. Effect of bromfenac ophthalmic solution on ocular inflammation following cataract surgery. Acta Ophthalmol. 2009; 87:300–305.
12. Simone JN, Pendelton RA, Jenkins JE. Comparison of the efficacy and safety of ketorolac tromethamine 0.5% and prednisolone acetate 1% after cataract surgery. J Cataract Refract Surg. 1999;25:699-704.
13. Barba KR, Samy A, Lai C, Perlman JI, Bouchard CS. Effect of topical anti-inflammatory drugs on corneal and limbal wound healing. J Cataract Refract Surg. 2000;26:893-7.
14. Jabs DA, Nussenblatt RB, Rosenbaum JT; Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005;140:509-16.
15. Zaczek A, Artzen D, Laurell CG, Stenevi U, Montan P. Nepafenac 0.1% plus dexamethasone 0.1% versus dexamethasone alone: effect on macular swelling after cataract surgery. J Cataract Refract Surg 2014;40:1498 505.
16. Duong HQ, Westfield KC, Singleton IC, Comparing Three Post-Op Regiments for Management of Inflammation Post Uncomplicated Cataract Surgery. “Are Steroids Really Necessary?”, J Clin Exp Ophthalmol 2011;2:163.
17. Walter KA, Estes AJ, Watson S, Ellingboe M. Management of Ocular Inflammation following Routine Cataract Surgery— Topical Corticosteroid (Prednisolone) versus Topical Non-steroidal (Bromfenac). US Ophthalmic Review 2011;4:97–100.
18. Wang QW, Yao K, Xu W, Chen PQ, Shentu XC, Xie X, Weng Y, Zhang L, Jin CF, Wu W, Zhu YN, Yu YH. Bromfenac sodium 0.1%, fluorometholone 0.1% and dexamethasone 0.1% for control of ocular inflammation and prevention of cystoid macular edema after phacoemulsification. Ophthalmologica. 2013;229:187 94.
19. Kessel L, Tendal B, Jørgensen KJ, Erngaard D, Flesner P, Andresen JL, Hjortdal J. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: a systematic review. Ophthalmology. 2014;121:1915-24.
20. Wittpenn JR, Silverstein S, Heier J, Kenyon KR, Hunkeler JD, Earl M; Acular LS for Cystoid Macular Edema (ACME) Study Group. A randomized, masked comparison of topical ketorolac 0.4% plus steroid vs steroid alone in low-risk cataract surgery patients. Am J Ophthalmol. 2008;146:554-560.