Diclofenac induces less IOP rise compared with steroids after strabismus surgery

Topical diclofenac provides comparable anti-inflammatory action to steroids, but with a lower increase in IOP, according to a prospective study by researchers in India.

Abadan K. Amitava, MD, and colleagues at JN Medical College, Aligarh, compared the anti-inflammatory effects and the effects on IOP between topical diclofenac 0.1% to dexamethasone 0.1% after strabismus surgery in a double-masked clinical trial. The study included 43 children with constant horizontal strabismus who qualified for standard uniocular recession-resection surgery on two horizontal rectus muscles, according to the study.

The researchers randomly assigned 21 patients to receive dexamethasone and 22 patient to receive diclofenac. Both were comparable in age, gender, preoperative IOP, strabismic status and baseline IOP.

Inflammatory characteristics, including discomfort, chemosis and discharge, were graded on a scale from 0 to 3, with 3 being severe. Both groups were similar in inflammatory characteristics and were followed out to 4 weeks.

The researchers found that IOP was significantly higher at 2 and 4 weeks in the dexamethasone group compared with the diclofenac group, according to the study.

"Topical diclofenac is comparable to dexamethasone in providing anti-inflammatory and analgesic effect with the advantage of significantly lesser IOP rise and should be preferred after strabismus surgery," the authors said.

The study is published in the Indian Journal of Ophthalmology.