Published: 2016-12-21

To compare the efficacy and preserved/preservative free nepafenac eye drops in the post cataract inflammation patients

Preet Sood, Manmohan Bhanot, Narinder Singh


Background: Nepafenac is a novel topical NSAID used to treat post operative ocular inflammation and pain. Benzylkonium chloride is used as preservative in the formulation, is notorious in causing ocular surface defect. Now a day, preservative free formulation is available. This study is the comparison of the efficacy and safety of preservative free nepafenac with standard nepafenac eye drop formulation.

Methods: This is a prospective investigator masked randomised parallel trial. Total n= 104 patients were enrolled. After randomization, patients were divided into two groups (nepafenac with\without preservative drug).Patients were examined preoperatively (day-1) and post operatively on days 1, 3, 5, 7, 15 and 30 days. The signs of inflammation and tear film break up time were recorded.

Results: preservative free nepafenac was found better at certain points like aqueous cells at day15 (p=0.02), conjunctival hyperemia at day 5 (p=0.009) and pain at day3 (p=0.004) at other points. Effect on tear film breakup time was recorded but it is not statistically significant.

Conclusions: preservative free nepafenac is found effective in controlling the ocular post inflammation. For evaluating the effect on dryness of eye we need longer trials. Preservative free nepafenac should be preferred over the nepafenac eye drops.


Benzalkonium chloride, Cataract, Nepafenac, Post operative inflammation, Tear film breakup time

Full Text:



Nardi M, Lobo C, Bereczki A, Cano J, Zagato E, Potts S, et al. Analgesic and anti-inflammatory effectiveness of nepafenac 0.1% for cataract surgery. Clin Ophthalmol. 2012;6:997-1004.

Huang C, Chen W, Chen Y, Liu Z. Toxicity research status of benzalkonium chloride on ocular surface. Br J Ophthalmol. 2011;95(6):869-75.

Woods CA, Cumming B. The impact of test medium on use of visual analogue scales. Eye Contact Lens 2009;35:6-10.

Weber BME, Arnoux YV, Jaulerry SD, LeHoang P, Colin J. Comparison of the efficacy and safety of two formulations of diclofenac sodium 0.1% eye drops in controlling postoperative inflammation after cataract surgery. Eur J Ophthalmol. 2005;15(6):702-11.

Maca, Chiambaretta F, Creuzot-Garcher C, Pilon F. Ocular tolerance of a new formulation of non-preserved diclofenac. J Fr Ophtalmol. 2004;27:739-44.

Huber-van der Velden KK, Thieme H, Eichhorn M. Morphological alterations induced by preservatives in eye drops. Ophthalmologe. 2012;109(11):1077-81.