Published: 2017-05-23

Comparison of efficacy of difluprednate 0.05% vs dexamethasone 0.1% eye drops in inflammation associated with small incision cataract surgery

Preet Sood, Manmohan Bhanot


Background: Post operative ocular inflammation is a common happening after any type of surgery. Corticosteroids have been used to treat ocular inflammation however, they carry a risk of side effects, particularily an increase in IOP. A newer steroid, difluprednate is found to be safe than dexamethasone.

Methods: Total 120 patient undergoing small incision cataract surgery was enrolled in this prospective, randomized and single blind (investigator masked) parallel study. Either of the two eye drops (dexamethasone/difluprednate) were prescribed post operatively. Patients were examined on postoperative day 1, 7, 14 and 28 for - Intraocular pressure, anterior chamber cells and flare with slit lamp examination.

Results: As difluprednate was found effective in reducing pain in 62% of the patients on day 3 as compared to dexamethasone group on day 7 i.e.76% of the patients. Both the drugs has no significant effect on the intraocular pressure.

Conclusions: Patients in difluprednate preparation have shown good compliance owing to the lesser frequency of drug administration. Better tolerability because of the emulsion form is also an encouraging factor. The only discouraging factor for difluprednate preparation is the cost. As the frequency of drug administration as compared to dexamethasone is less (QID), it is compromised a bit.


Difluprednate, Dexamethasone, Post ocular inflammation, Small incision cataract surgery

Full Text:



Simone JN, Whitacre MM. Effects of anti-inflammatory drugs following cataract extraction. Curr Opin Ophthalmol. 2001;12:63-7.

Rhen T, Cidlowski JA. Anti inflammatory action of glucocorticoids: new mechanisms for old drugs. N Engl J Med. 2005;353:1711-23.

McColgin AZ, Heier JS. Control of intraocular inflammation associated with cataract surgery. Curr Opin Ophthalmol. 2000;11:3-6.

Becker B. Intraocular pressure response to topical corticosteroids. Invest Ophthalmol. 1965;4:198-205.

Campos M, Mariana Á, Wallau A, Muccioli C, Höfling-Lima AL, Belfort R. Efficacy and tolerability of a fixed-dose moxifloxacin- dexamethasone formulation for topical prophylaxis in LASIK: a comparative, double-masked clinical trial Clin Ophthalmol. 2008 Jun;2(2):331-8.

Cable MM. Intraocular pressure spikes using difluprednate 0.05% for postoperative cataract inflammation. Assoc Res Vis Ophthalmol Ann Meet Abstr. 2010;51:198413.

Stephen S, Douglas L, Peace J, McLeod K, Crockett RS, Vogel R. Difluprednate ophthalmic emulsion 0.05% (Durezol) administered two times daily for managing ocular inflammation and pain following cataract surgery. Clin Ophthalmol. 2010;4:983-9916.

Freitas L, Soriano E, Muccioli C, Hofling-Lima AL, Belfort R. Efficacy and tolerability of a combined moxifloxacin/ dexamethasone formulation for topical prophylaxis and reduction of inflammation in phacoemulsification. A comparative double masked clinical trial. Current Medical Research and opinion. 2008;23(12):3123-30.

Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of Uveitis Nomenclature (SUN) working group: Standardization of Uveitis Nomenclature (SUN) for reporting clinical data. Results of the first international workshop, Am J Ophthalmol. 2005;140;509-16.

Gordon DM. Use of dexamethasone in eye. The Journal of the American Medical Association. 1960;172(4):311-12.

Abelson MB, Butrus S. Corticosteroids in ophthalmic practice. Albert and Jakobiec’s; Principles and Practice of ophthalmology. 3rd Ed. 2008;23:249-250.

Bharolia AC, Raja AH. A Retrospective Study to Compare Moxifloxacin-Dexamethasone and Moxifloxacin-Difluprednate Eye Drops In Post Cataract Surgery. International journal of scientific research. 2016;5(4).

Chaudhary N, Arora I, Gupta DC, Gupta CP. Comparison of efficacy and safety of dexamethasone 0.1%and difluprednate 0.05% in the management of ocular inflammation after phacoemulsification Journal of medical and dental sciences. 2015;4(74):12899-903.

Meehan K, Vollmer L, Sowka J. Intraocular pressure elevation from topical difluprednate use. Optometry. 2010;81(12):658-62.