A Comparative Study of Various Topical Nonsteroidal Anti-Inflammatory Drugs to Steroid Drops for Control of Post Phacoemulsification Surgery Inflammation

Abstract

In the past, patients who underwent cataract surgery were prescribed an antibiotic drop and a topical steroid to reduce inflammation in the days following the procedure. However, steroids can have negative consequences, such as slowed wound healing, increased susceptibility to infection, and increased intraocular pressure (IOP) that can cause permanent damage to the optic nerve. Bromfenac is an NSAID that has been demonstrated to reduce post-operative pain and inflammation and is associated with better adherence (since it needs to be taken less frequently) and fewer adverse effects. The purpose of this research was to evaluate the efficacy of a topical steroid against a topical NSAID in the prevention and treatment of inflammation following phacoemulsification surgery. Methods: Eighty eyes from eighty patients who had conventional uncomplicated phaco emulsification with posterior chamber intra ocular lens implantation were used in this prospective randomised study comparing the effect of topical non-steroidal anti-inflammatory drugs versus steroidal drugs in preventing post-operative inflammation following phaco emulsification surgery. Patients were randomly assigned to one of two groups based on whether they received oral or topical medication for the first three weeks after surgery. Twenty patients were assigned to Group A, where they received prednisolone 1% eye drops every two hours for the first week, four times a day for the second week, twice a day for the third week, and gatifloxacin 0.3% six times a day for the entire two weeks. For those in B-Group: For Group B, we divided 60 eyes into three categories: Group B1 received eye drops containing 0.1% diclofenac sodium, while Group B2 received eye drops containing 0.1% nepafenac. The Bromfenac 0.1%.eye drop group B3 treated 20 eyes. While the first week showed statistically significant differences in corneal edoema, anterior chamber cells, and flare, by the third week the results were similar across all four groups. In terms of eyesight, we also discovered a statistically significant difference between Group A and Groups B1, B2, and B3, but this difference had diminished by the third visit. Up to the last visit of the third week, there was no significant difference between the four groups' IOP measurements. Our data demonstrated a marginally different response to steroid or NSAID use, with the steroid group experiencing less corneal edoema than the NSAID group up to the third week visit. Patients undergoing phacoemulsification surgery can benefit from nonsteroidal anti-inflammatory drugs (NSAIDs) like nepafenac 0.1%, bromfenac 0.1%, and Diclofenac sodium 0.1% instead of steroids for postoperative ocular inflammation control. Intraocular inflammation is best treated with prednisolone 1% as it achieved reduced AC cells and flare.