An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate

Authors

  • Sadhana K. Hingorani Department of Pharmacology, SMIMER, Surat, Gujrat, India
  • Anupama S. Desai Department of Pharmacology, SMIMER, Surat, Gujrat, India
  • Manisha B. Shastri Department of Ophthalmology, SMIMER, Surat, Gujrat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20202945

Keywords:

Difluprednate, Dexamethasone, Intra-ocular pressure

Abstract

Background: Cataract is the leading cause of blindness worldwide. Treatment of cataract is surgical. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by topical steroids (dexamethasone and difluprednate) and to detect adverse effects.

Methods: All patients operated by phacoemulsification in ophthalmology Department of SMIMER Surat were taken as subjects. Depending on topical steroids prescribed after surgery, subjects were separated into 2 groups, group 1 - difluprednate and group 2 - dexamethasone. Changes in intra-ocular pressure (IOP) of patients were collected from the data available pre-operative, 1st ,2nd ,3rd ,4th week after surgery and were analyzed. Other parameters whose data were collected are-adverse effects and compliance of patients.

Results: In group 1 preoperative mean IOP was 15.5. At the end of 1st week, the mean IOP was significantly increased to 15.8. There was equal rise in IOP during 3rd week and 4th week which means that after 3rd week IOP remains stable. In group 2 preoperative mean IOP was 15.4. At the end of 1st, 2nd, 3rd and 4th there was significant increase in IOP as compared to preoperative mean IOP. Adverse effects were reported more in group 2.

Conclusions: In group 1 there was a rise in IOP up to three weeks but after 3rd week IOP remained stable. In group 2 rise in IOP was seen throughout 4 weeks of treatment. Adverse effects seen more in group 2. Compliance of patients was better in group 1.

Author Biographies

Sadhana K. Hingorani, Department of Pharmacology, SMIMER, Surat, Gujrat, India

Department of pharmacology,SMIMER ,Surat

Anupama S. Desai, Department of Pharmacology, SMIMER, Surat, Gujrat, India

Department of pharmacology,SMIMER ,Surat

Manisha B. Shastri, Department of Ophthalmology, SMIMER, Surat, Gujrat, India

Department of opthalmology,SMIMER

References

The Loteprednol Etabonate Post-operative Inflammation Study Group 2. A double-masked, placebo-controlled evaluation of 0.5% loteprednol etabonate in the treatment of post-operative inflammation. The Loteprednol Etabonate Postoperative Inflammation Study Group 2. Ophthalmology. 1998;105:1780-6.

Bron A, Denis P, Xuan HTC. The effects of rimexolone 1% in postoperative inflammation after cataract extraction. A double-masked placebo-controlled study. Eur J Ophthalmol. 1998;8:16-21.

Korenfeld MS, Silverstein SM, Cooke DL, Vogel R, Crockett RS. Difluprednate ophthalmic emulsion 0.05% for postoperative inflammation and pain. J Cataract Refract Surg. 2009;35:26-34.

Stewart R, Horwitz B, Howes J, Novack GD, Hart K. Double-masked, placebo-controlled evaluation of loteprednol etabonate 0.5% for postoperative inflammation. Loteprednol Etabonate Post-operative Inflammation Study Group 1. J Cataract Refract Surg. 1998;24:1480-9.

Campos M, Avila M, Wallau A, Muccioli C, Lima HAL, 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;2:331-8.

Holland EJ, Djalilian AR, Sanderson JP. Attenuation of ocular hypertension with the use of topical loteprednol etabonate 0.5% in steroid responders after corneal transplantation. Cornea. 2009;28:1139-43.

Seah SK, Husain R, Gazzard G. Use of surodex in phacotrabeculectomy surgery. Am J Ophthalmol. 2005;139:927-8.

Vetrugno M, Maino A, Quaranta GM, Cardia L. The effect of early steroid treatment after PRK on clinical and refractive outcomes. Acta Ophthalmol Scand. 2001;79:23-7.

Neil RP, Schein OD, Gieser SC. Synthesis of the Literature on Visual Acuity and Complications Following Cataract Extraction with Intraocular. Lens Implantation Arch Ophthalmol. 1994;112(2):239-52.

Laurell CG, Zetterstrom C. Effects of dexamethasone, diclofenac, or placebo on the inflammatory response after cataract surgery. Br J Ophthalmol. 2002;86:1380-4.

Garrick C, Kiely AE, Challa P. Topical Corticosteroid and NSAID Therapies for Ocular Inflammation. Cataract Refractive Surg Today. 2014:15-20.

Hazarika AK. Benefits and Risk of Topical Corticosteroids in the Management of ocular Inflammation. SMU Med J. 2015;2(2):1604-2349.

Mochizuki M, Ohno S, Usui M, Masuda K, Sekiya T, Ogawa T, et al. A Phase III, Open-Label, Clinical Study of Difluprednate Ophthalmic Emulsion (DFBA), 0.05%, in the Treatment of Severe Refractory Anterior Uveitis. Investigative Ophthalmology Visual Sci. 2007;48:3905.

Patil A, Gupta V, Sethi H, Nehate R. A comparative evaluation of anti-inflammatory efficacy of various ophthalmic steroids in post phaco-emulsification patients. ESCRS. 2016;9(3):150-6.

Ohno S, Mochizuki M, Usui M, Miyake S, Nagai N, Ozawa Y, et al. A phase III noninferiority study of difluprednate ophthalmic emulsion 0.05% in the treatment of anterior uveitis. Invest Ophthalmol Vis Sci. 2012;53(14):2568.

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Published

2020-06-26

How to Cite

Hingorani, S. K., Desai, A. S., & Shastri, M. B. (2020). An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate. International Journal of Basic & Clinical Pharmacology, 9(7), 1079–1083. https://doi.org/10.18203/2319-2003.ijbcp20202945

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Section

Original Research Articles