Title: Effects of Anti Inflammatory Agents Following Cataract Surgery
Authors: Mithilesh Haldar, Kanchan Kumar Mondal, Sabyasachi Bandyopadhyay, Sujash Haldar, Supreeti Biswas
DOI: http://dx.doi.org/10.18535/jmscr/v4i7.38
Objectives: To assess and compare the analgesic and anti inflammatory efficacy of nepafenac and prednisolone eye drops used individually and in combination in post-operative period of cataract surgery by estimating anterior chamber cell count(ACCC) and pain in visual analogue scale(VAS). Materials and Methods: A total of 156 subjects after cataract surgery were allocated through lottery to 3 groups (n=52 each). Group A: with topical nepafenac: 1 drop thrice daily for 3 weeks, Group B with topical prednisolone: 1 drop four times daily for 3 weeks. Group C with combination of nepafenac and prednisolone as per the schedule for group A and B respectively. Drugs were continued for 22 consecutive days and there were four follow-up visits on day 4, day 8, day 15 and day 22. Anterior chamber cell count (ACCC) and pain were determined by slit lamp bio microscope and visual analogue scale respectively. Results: End results of group A for ACCC and pain were 5.41 ± 0.44 and 1.27 ± 0.41 respectively. In case of group B, ACCC and pain were 1.09 ± 0.32 and 0. Group C showed the best results where for ACCC and pain were 0.40 ± 0.22 and 0 respectively. Conclusion: Combination of Prednisolone and nepafenac eye drops was the most efficacious in reducing inflammation and pain after cataract surgery. Key Words: Cataract surgery, prednisolone and nepafenac. 1. Sihota R, Tandon R .Chapter-18, The lens, Parson’s Diseases of the Eye 19th edition : Butterworth- Heineman : 2003 : 274. 2. Boyle E, Atersitz K . Study: High prevalence of cataracts continues, Ocular Surgery News India Edition. 2008: 32 3. Murthy CV, Gupta SK . Prevalence of lens opacities in North India : The INDEYE feasibility study . Invest Ophthalmol vis Sci. 2007; 48: 88-95 4. Balsubramanian D, Seetharam BK and Gullapalli RK . Factors in the prevalence of cataract in India – Analysis of recent Indo- US study of age related cataracts. Current science. 1990; 59(10) : 498. 5. Ocampo VD, Foster CS . Cataract, Senile, WebMD professional . May 20, 2009:92. 6. Reddy MK . Complications of cataract surgery , Indian J Ophthalmol 1995; 43(4): 201-9 7. Muddappa TM, Srinivaso Rao PN . Post operative complications in cataract surgery with reference to the type of section and the number of sutures , Indian J. Ophthalmol . 1982 ;30: 461-2. 8. Colin J , Paquette B . Comparison of the analgesic efficacy and safety of nepafenac ophthalmic solution compared with diclofenac ophthalmic solution after excimer laser surgery , Elsevier Periodicals .2006; 28(4) ; 527- 36 . 9. Heaton J, Hidden JW, Hackett RB, Rice RL and Grubbel MM . Ocular effects of Nepafenac ophthalmic suspension, Invest Ophthalmol Vis Sci 2005; 46: 2650. 10. Eric JW , Braunstein A, Shih C , Braunstein RE. Incidence of visually significant pseudophakic macular edema after uneventful phacoemulsification in patients treated with Nepafenac . J cataract refractive Surg . 2007; 33(9): 1546 – 9. 11. Nardi M, Lobo C, Bereczki A, . Analgesic anti-inflammatory effectiveness of Nepafenac 0.1% for cataract surgery. Clin Ophthalmol . 2007 ; 1 : 527-33. 12. Tracy TS, Marra C, Wrighton SA, Gonzalez F and Kozekwak R. Studies of flurbiprofen 4-hydroxylation : Additional evidence suggesting the sole involvement cytrochrome P4502C9, Biochemical Pharmacology. 1996;52(9) : 1305- 9. 13. Varma MM, Pandi JK. Dissolution ,solubility, XRD and DSC studies on flurbiprofen-nicotinamide solid dispersion, Drug Dev Ind Pharm. 2005;31(4-5) :417-23. 14. Fujishima H, Fukagawa K, Takano Y, Okamoto S, Miyazaki D, Yamada J, Fukushima A, Uchio E and Nakagawa Y. Comparison efficacy Bromfenac sodium 0.1% ophthalmic solution fluorometholone 0.02% ophthalmic suspension for the treatment of allergic conjunctivitis, J Ocul Pharmacol Ther . 2009;25(3): 265-70. 15. Endo N, Kato S, Haruyama K, Shoji M and Ketano S. Efficacy of Bromfenac sodium ophthalmic solution in preventing cystoid macular oedema after cataract surgery in apatients with diabetes, Acta ophthalmologica. 2009:1755-68. 16. Marra SM, Amon M, Findi O, and Kahraman G. Efficacy and tolerability of preservative free and preserved diclofenac and preserved ketorolac eye drops after cataract surgery, Am J Ophthalmol. 2010; 149(5): 777-84. 17. Ahuja M, Avinash S, Dhake AJ, Suresh K, Majumdar DK. The AAPS Journal . 2008;10(2) :3. 18. Bourgault S, Chmielewska K, Tourville E . Prophylaxis and Treatment of Irvine- Gas syndrome . Clin Surg Ophthalmol 2010 ; 28(2) :5. Abstract
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