Comparison of a preservative-free nonsteroidal anti-inflammatory drug and preservative-free corticosteroid after uneventful cataract surgery: multicenter, randomized, evaluator-blinded clinical trial.

Seonjoo Kim, Byung-Yi Ko, Jae Woong Koh, Eun Chul Kim, Hong Kyun Kim, Young Joo Shin, Jong-Suk Song, Do Hyung Lee, Ji Eun Lee, Hyung Keun Lee, So-Hyang Chung, Hyun Seung Kim

Journal: Journal of cataract and refractive surgery 2022;48(6):710-716

PMID: 34629379

Free Full Text on PubMed Central View on PubMed

Abstract

PURPOSE

To compare the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) and steroidal eyedrops for inflammation management after cataract surgery using slitlamp indicators.

SETTING

11 eye centers in South Korea.

DESIGN

Randomized prospective multicenter study with a blinded evaluator.

METHOD

In 125 (250 eyes) patients who underwent cataract surgery, bromfenac sodium hydrate 0.1% (NSAID group) was applied twice a day in 1 eye, whereas the other eye was treated with fluorometholone 0.1% (steroid group), 4 times a day for 4 weeks postoperatively. The primary efficacy outcome was the presence of anterior chamber cells and flare at 1 week postoperatively. Anterior chamber cells and flare at 4 to 8 weeks, corrected distance visual acuity, central corneal thickness, conjunctival hyperemia, dry eye parameters, foveal thickness, and ocular and visual discomfort were evaluated as secondary outcomes.

RESULTS

At week 1, residual anterior chamber inflammation was not statistically significantly different between the groups (-1.03 ± 1.27 vs -0.95 ± 1.24, P = .4850). However, the NSAID group recovered from conjunctival hyperemia more rapidly than the steroid group (0.30 ± 0.52 vs 0.44 ± 0.81, P = .0144 at week 1). The increase in central corneal thickness in the NSAID group was less than that in the steroid group 1 week postoperatively (7.87 ± 22.46 vs 29.47 ± 46.60 μm, P < .0001). The change in foveal thickness in the NSAID group was significantly less than that in the steroid group (18.11 ± 68.19 vs 22.25 ± 42.37 μm, P = .0002). Lower levels of postoperative ocular and visual discomfort were reported in the NSAID group than in the steroid group under treatment.

CONCLUSIONS

Preservative-free bromfenac was as effective as preservative-free fluorometholone eyedrops in anterior chamber inflammation control and showed better signs and symptoms after cataract surgery.

Address: From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee).

DOI: 10.1097/j.jcrs.0000000000000841

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/cataract.html

Subscription / membership required

Full Text Sources:

MeSH Terms: Adrenal Cortex Hormones, Anti-Inflammatory Agents, Non-Steroidal, Cataract, Cataract Extraction, Fluorometholone, Humans, Hyperemia, Inflammation, Ophthalmic Solutions, Phacoemulsification, Postoperative Complications, Preservatives, Pharmaceutical, Prospective Studies, Treatment Outcome