A comparative study of various topical nonsteroidal anti-inflammatory drugs to steroid drops for control of post cataract surgery inflammation

BACKGROUND: Postoperative inflammation continues to be a cause of patient discomfort, delayed recovery, and in some cases, suboptimal visual results. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid are commonly used in the management and prevention of noninfectious ocular inflammation following cataract surgery. AIMS: The aim was to study the safety and efficacy of various NSAIDs drops for control of postoperative inflammation following cataract surgery and compare with steroid eye drops in a patient following cataract surgery. SUBJECTS AND METHODS: Totally, 200 patients undergoing phacoemulsification with posterior chamber intraocular lens implantation were randomly assigned to receive either nepafenac 0.1% 3 times daily, bromfenac 0.09% twice daily, ketorolac 0.5% 4 times daily for 1 month or 1% prednisolone eye drops as their postoperative anti-inflammatory medication with 50 cases in each group. The patients were examined at the 1(st) day (baseline), 1(st) week, 2(nd) week, and 4(th) week after surgery. Postoperative inflammation was evaluated subjectively by intraocular pressure, slit-lamp assessment of signs of inflammation, including conjunctival hyperemia, ocular pain, and aqueous cells and flare. STATISTICAL ANALYSIS: Statistical analysis was performed by the SPSS program for Windows, version 17.0. RESULTS AND CONCLUSIONS: In our study, we found that prednisolone 1% was more effective in controlling postoperative intraocular inflammation in terms of reducing anterior chamber cells and flare. We found that ketorolac 0.5% and nepafenac 0.1% were equally effective in controlling postoperative ocular pain and inflammation. All four drugs are effective in controlling post cataract surgery ocular inflammation. Intraocular inflammation is best controlled with prednisolone 1%, while ocular pain and hyperemia are better controlled with NSAIDs in the early postoperative periods.