Abstract
Purpose:To compare the effects of topical corticosteroid with non-steroidal anti-inflammatory agents on postoperative control of inflammation, pain and corneal astigmatism.
 Setting: Indira Gandhi Government General Hospital & Postgraduate Institute, Puducherry.
 Methods:A prospective comparative study in two hundred patients with visually significant cataract, undergoing manual small incision cataract surgery with implantation of posterior chamber intraocular lens were randomly assigned into four groups with minimum 50 patients in each. All cases of uncomplicated cataract surgery were assigned to following groups to receive one of the following topical anti-inflammatory agents as postoperative medications: Group A- 1% predinsolone acetate, Group B -0.5% ketorolac tromethamine, Group C 0.09% Bromfenac eye drops, Group D 0.1% Nepafenac eye drops. All patients were examined on 1 day (baseline), 3th day, 5th day, 7th day, 14th day and 1month after surgery for assessment of ocular pain, anterior chamber cells and flare and corneal astigmatism.
 Results:The cells and flare were least in bromfenac group on the 3rd postoperative day.Nepafenac is effective in inflammation control from 5th postoperative day. There was a significant association of use of drug and severity of ocular pain upto 1stpostoperative week. There was statistically significant difference between NSAIDs and steroid on postoperative astigmatism (P <0.001).
 Conclusions:Bromfenac is effective as an anti-inflammatory agent in the immediate postoperative period. All the NSAIDs are found to be as effective as steroid after 1 week onwards. The NSAIDs showed reduced astigmatism changes and stabilizes astigmatism much quicker than steroids.
Highlights
Cataract surgery techniques have improved tremendously in the past few decades with small incision cataract surgery (SICS) nowadays being the standard treatment
There was significant difference observed between bromfenac versus prednisolone group and bromfenac versus ketorolac group on 1st post op days (p
The results indicates bromfenac is more effective in controlling inflammation in 3rdPOD than nepafenac and ketorolac group
Summary
Cataract surgery techniques have improved tremendously in the past few decades with small incision cataract surgery (SICS) nowadays being the standard treatment This modern surgery has resulted in decrease in physical trauma to ocular tissues [1]. Corticosteroids have been the drug of choice and considered as gold standard for treatment of ocular inflammation after cataract surgery [1] Effective, these drugs are associated with an increased incidence of adverse effects like cataract formation [4] , a rise in IOP, increased susceptibility to herpetic infections [5] due to a suppressed host immune response and retardation in corneal epithelial [2][2] and stromal wound healing [6][6]
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