Efficacy and safety comparison of topical loteprednol and topical non-steroidal anti-inflammatory drugs in seasonal allergic conjunctivitis: a prospective open label comparative study

Abstract

Background: Seasonal allergic conjunctivitis (SAC) one of the most common ocular immunological disorder affecting wide population. Various classes of drugs are been used to control allergic inflammation. Traditionally topical glucocorticoids have been used for SAC. However, repeated and continuous use of steroids is associated with various complications like increase in intraocular pressure, posterior sub capsular cataract, increased susceptibility for infections and delayed wound healing. Hence the current emphasis is to prefer topical NSAIDs as they are free from various steroid related complications. As there is paucity of information regarding the comparative efficacy of topical steroids and NSAIDs, the present study was taken up. The main objective was to study the comparative efficacy and safety of three topical NSAIDs: flurbiprofen, diclofenac, ketorolac and the topical steroid loteprednol, in SAC. Methods: A prospective, comparative study enrolled 40 patients for SAC. All study drugs were instilled 4 times daily for 4 weeks. Patients were assessed for objective and subjective parameters of inflammation at baseline and weekly intervals for 4 weeks using four point scales, and also observed for any side effects. The anti-inflammatory action was assessed by the change in mean scores from basal and at various intervals. Results: Loteprednol was more effective than the three NSAIDs, only ketorolac comparable to loteprednol in relieving ocular itching. Study drugs showed good safety and tolerability, with only minimal local side effects. Conclusions: SAC the topical steroid loteprednol was found superior to NSAIDs.