Lower-concentration NSAID reduces pain, inflammation after cataract surgery

Bromfenac ophthalmic solution 0.07% dosed once daily reduced intraocular inflammation and pain after cataract surgery when compared with placebo, according to a study.

Perspective from Bonnie An Henderson, MD

In two prospective, double-masked, phase 3 clinical trials, 222 patients randomized to receive once-daily Prolensa (bromfenac ophthalmic solution 0.07%, Bausch + Lomb) experienced less pain and inflammation and fewer adverse events than did 218 patients randomized to receive placebo.

The dosing regimen was followed for 16 days: one drop the day before cataract surgery with posterior chamber IOL implantation, one drop the day of surgery and one drop each day for 14 days afterward.

A statistically significant higher percentage of patients in the bromfenac group (48.6%) attained total clearance of ocular inflammation by day 15 than did patients in the placebo group (24.3%, P < .0001). The percentage of patients in the bromfenac group who were pain-free at day 1 postoperatively was also statistically significantly higher (78.8% vs. 49.5%, P < .0001).

Ocular pain, foreign body sensation, anterior chamber inflammation, blurred vision and photophobia were reported as adverse events in the bromfenac group. Overall, 35.6% of patients experienced an adverse event, although the rate was lower in patients in the bromfenac group (28.8%) than in the placebo group (42.6%).

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.

Perspective

Bonnie An Henderson, MD

A new formulation of bromfenac, with a lower concentration and lower pH, is just as effective as the higher concentration and appears to control inflammation and pain after cataract surgery. Doctors are continually attempting to minimize the side effect of medications while maintaining the efficacy of treatment. Therefore, a new formulation that decreases the concentration is a welcome modification when addressing postoperative inflammation.

This study highlights not only the benefits of bromfenac 0.07% but also shows us that the use of an NSAID after cataract surgery is necessary. When comparing the postoperative symptoms after cataract surgery in patients who received placebo vs. bromfenac, it is clear that patients who received placebo took longer to heal and had more postoperative pain. This is yet another study that underlines the benefits of topical NSAIDs after cataract surgery.

Bonnie An Henderson, MD

OSN Cataract Surgery Board Member

Disclosures: Henderson is a consultant for Bausch + Lomb and Alcon.

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Sources/Disclosures

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Source: Ophthalmology 2014;121(1):25-33.