Comparative study of topical steroids vs nonsteroidal anti-inflammatory drugs to control postcataract surgery inflammation.

PURPOSE: To evaluate the efficacy of bromfenac ophthalmic solution 0.09% in comparison with topical steroids after phacoemulsification cataract surgery, while specifically looking at differences in visual acuities, anterior chamber reaction, and central retinal thickness changes.

SETTING

Mission Nethralaya, India.

DESIGN

Prospective, randomized, investigator-masked, comparative clinical trial.

METHODS

Patients were randomly assigned to 3 treatment groups: In group I, bromfenac was prescribed 3 times a day for 1 month; in group II, prednisolone acetate 1% eye suspension was prescribed 4 times a day for 1 month; and in group III, prednisolone acetate 1% was prescribed 4 times a day for 2 weeks and bromfenac 2 times a day for 1 month. All patients received anti-infective preoperative and postoperative standards of care. Study visit assessments included corrected distance visual acuity, biomicroscopy, intraocular pressure, adverse events, and concomitant medication review. Optical coherence tomography was performed on postoperative days 7, 21, and 60.

RESULTS

Each group included 150 eyes. All treatment groups had similar baseline measurements. There was a significant difference in anterior chamber reaction observed between group I and group II (P < .001) and group I and group III (P < .001) on postoperative days 1 and 7. On postoperative day 21, thickening of the central fovea was observed in group II as compared with group I and group III. This difference was statistically significant (P < .001).

CONCLUSIONS

The combination of topical nonsteroidal anti-inflammatory drugs and topical steroids resulted in positive clinical outcomes after cataract surgery.