Résumé
Introduction: Phacosmulsification with IOL implantationis currently the procedure of choice for cataract surgeryas it offers the best visual results. Two main groups ofdrugs used to control postoperative inflammation followingcataract surgery are NSAIDS, which directly inhibit the coxenzymes and topical corticosteroids, which act at the level ofphospholipase A2. Study objective was to compare the efficacyof 0.05% difluprednate emulsion and 1% prednisolone acetatesuspension on post phaco inflammation.Material and methods: 80 patients undergoingphacoemulsification in tertiary health care centre wererandomly divided into 2 groups. Postoperatively, patients ingroup A were put on 0.05% difluprednate eye drops whilegroup B were put on 1%prednisolone acetate eye drops for 42days each. At each visit evaluation was done for BCVA, IOP,ocular pain grading, slit lamp for aqueous cells/ flare score.Results: At end of study, 97.5% patients in group A and 95%patients in group B had BCVA of 6/6. None of patients inany group showed significant rise in IOP >21mmHg. 95%patients in both groups showed ocular pain grade of 1 while2% patients in group A and 1% in group B showed ocular paingrade of 2. 97.5%in group A and 95% in group B presentedwith 100% aqueous cell clearing while 97.5% patients in bothgroups and showed flare score 0 at last follow up.Conclusion: Topical 0.05%difluprednate ophthalmicemulsion is as effective as 1% prednisolone acetate in treatingpost phacoemulsification inflammation with the advantage ofuniform drug dosage and no preservative.
Résumé
Postoperative operative inflammation following cataract surgery is common occurrence may be due to severalsurgery-dependent factors such as surgical trauma, intraocular lens type, and due to various physical, chemicaland biological agents introduced during surgery and also on patient-dependent factors such as history ofinflammatory disease and degree of iris pigmentation. Anti-inflammatory agents are routinely prescribedfollowing cataract extraction surgery to resolve signs and symptoms of inflammation more rapidly and toimprove patient comfort. For the treatment of postoperative ocular inflammation and pain the most widelyprescribed topical corticosteroid is betamethasone 0.1%, and Difluprednate ophthalmic emulsion 0.05% astrong topical steroid. Hence, this study was to compare the efficacy and safety of topical corticosteroidsDifluprednate 0.05% and betamethasone 0.1%, in managing inflammation and pain following post cataractextraction surgery. In a total 100 patients were randomized into two groups Group –A (50 patients) prescribingtopical Difluprednate emulsion 0.05% and Group-B (50 patients) prescribing betamethasone phosphate 0.1%.in our observation after 15 days no pain in group-A, after 30 days no one are having corneal oedema in groupA. Difluprednate emulsion 0.05% drug was efficient in the reduction of anterior chamber cells and flare withbetamethasone phosphate 0.1% being more rapid. Based on our findings and previous study results,Difluprednate emulsion 0.05% can be used in post-operative management post cataract surgery, however,further clinical trials with long follow- up periods are required.
Résumé
Aims: The study aims to compare the efficacy of the anti-inflammatory effect of 0.1% dexamethasone sodium and 0.05%difluprednate eye drops after small incision cataract surgery (SICS).Study Design: A prospective, randomized, and clinical study was conducted on patients.Place and Duration of Study: This study was conducted in the Department of Ophthalmology, VCGS Government MedicalCollege, Srinagar, Uttarakhand, between December 2017 and November 2018.Materials and Methods: This study included two groups of 40 patients each (a total of 80 patients). 40 patients in GroupA wererandomly started on 0.1% dexamethasone eye drops postoperatively and another 40 patients in Group B were randomly started0.05% difluprednate eye drops postoperatively. Response to the therapy was recorded on day 1, 7, and 40 on the parametersof post-operative anterior chamber reaction and post-operative visual acuity, and the results were compared.Results: All results were correlated with final visual outcome, and post-operative flare, which showed 0.05% difluprednate, isclinically and statistically more effective in early post-operative period than 0.1% dexamethasone sodium to control inflammationin uneventful SICS.Conclusions: After the comparison of the data in both the groups, the patients started on 0.05% difluprednate eye dropspostoperatively showed better response to therapy (P < 0.0001) with respect to the parameters of best-corrected visual acuityand post-operative flare as compared to the patients started on 0.1% dexamethasone sodium eye drop therapy postoperatively,indicating that 0.05% difluprednate eye drops have a better anti-inflammatory effect.