NSAID, steroid equally effective for post-phaco inflammation

STOCKHOLM, Sweden — Dexamethasone and diclofenac were equally effective in reducing postoperative inflammation after phacoemulsification and IOL implantation, according to a study. Both substances were more effective than placebo.

Researchers here at St. Erik's Eye Hospital conducted a prospective, randomized, double-masked study including 180 patients enrolled for cataract surgery. The patients ranged in age from 64 to 85, and no eye had any ocular disease other than cataract.

After phaco and IOL implantation, patients were randomized to topical treatment with either dexamethasone phosphate 0.1%, diclofenac sodium 0.1% or placebo. The drops were administered four times daily during the first week and twice daily during weeks 2, 3 and 4. Inflammatory reaction was measured preoperatively and 1, 3 and 8 days, 2 and 4 weeks, 2 and 6 months and 1, 2 and 4 years postoperatively. The rate of Nd:YAG laser posterior capsulotomy at 2 and 4 years was also recorded.

After days 3 and 8 and weeks 2 and 4, median flare was highest in the placebo group. There were no statistically significant differences between the dexamethasone and diclofenac groups. Inflammatory symptoms and striate keratopathy were more common in the placebo group.

The study is published in the December issue of British Journal of Ophthalmology.