The effects of Rimexolone 1% in postoperative inflammation after cataract extraction. A double-masked placebo-controlled study.

AIM: A multicentre, randomized, placebo-controlled double-masked study was conducted to assess the efficacy and safety of Rimexolone 1% eye drops in reducing inflammation after cataract surgery and intra-ocular lens implantation. METHODS: Rimexolone 1% (124 patients) or placebo (58 patients) was given, four times a day for 14 days starting 22-34 hours after surgery. All patients also received tobramycin 0.3% four times a day for 7 days. The clinical signs of ocular inflammation were recorded on days 1, 3, 8, 15 and 17 or 18. RESULTS: Rimexolone 1% markedly decreased the mean inflammation severity scores, and the sum of clinical assessments of cells and flare in the anterior chamber compared with placebo at each assessment. In addition, the percentage of patients with no anterior chamber inflammation was significantly higher with Rimexolone 1% than with the placebo at each assessment. All these results were statistically significant. Intra-ocular pressure did not rise after treatment with Rimexolone 1%. CONCLUSIONS: The results suggest that Rimexolone 1% ophthalmic solution is an effective and safe steroidal anti-inflammatory agent for topical use following cataract surgery and intra-ocular lens implantation.

Comparative study of the intraocular pressure effects of fluorometholone 0.1% versus dexamethasone 0.1%.

The intraocular pressure effect of fluorometholone 0.1% was compared with that of dexamethasone 0.1% by performing corticosteroid provocative tests on 24 matched pairs of eyes. Fifteen of the 24 dexamethasone treated eyes, 62.5%, showed a change in intraocular pressure greater than 5 mmHg, with mean delta P = 8.58 mmHg and range 0 to +20 mmHg. Only 2 of the 24 fluorometholone treated eyes, 8.3%, showed a change in pressure greater than 5 mmHg, with mean delta P = 2.96 mmHg and range -2 to +14 mmHg. There was a highly statistically significant difference between the intraocular pressure effects of topical dexamethasone and fluorometholone (correlated t test, p less than 0.001). Fluorometholone would appear to be the topical steroid of choice for patients with glaucoma and other known steroid responders when topical steroid treatment is indicated.

Corticosteroid-induced ocular hypertension. I. Prevalence in closed-angle glaucoma.

Forty-eight eyes with closed-angle glaucoma and 31 eyes at risk were subjected to corticosteroid provocative tests. 65% and 9.7% respectively responded with a change in pressure greater than or equal to 6 mmHg. The responses of the 2 groups were compared with each other and also with the corticosteroid pressure response in normal eyes. The differences in behaviour between the eyes with closed-angle glaucoma and eyes at risk, and the eyes with closed-angle glaucoma and normal eyes, are statistically highly significant. The implication of this are discussed. The prevalence of corticosteroid-induced ocular hypertension in closed-angle glaucoma is higher than previously reported.

Corticosteroid-induced ocular hypertension. II. An acquired form.

Thirty-five patients with unilateral closed-angle glaucoma treated by peripheral iridectomy and prophylactic peripheral iridectomy in the fellow eyes were subjected to corticosteroid provocative test in both eyes. 51% of the eyes with closed-angle glaucoma and 11% of their fellow eyes had a positive corticosteroid pressure response. The closed-angle glaucoma eyes had their fellow eyes responded differently as shown by the frequency distribution graphs and also by the difference between the corticosteroid-induced change in pressure (Wilcoxon test, z=-4.80, p less than 0.0001). These results provide evidence for an acquired form of corticosteroid-induced ocular hypertension and the possible pathogenic factors for the first time. The clinical significance of an acquired form of corticosteroid-induced ocular hypertension is discussed.