A comparative analysis of topical corticosteroids and non-steroidal anti-inflammatory drugs to control inflammation and macular edema following uneventful phacoemulsification

Purpose: To compare the efficacy of topical nonsteroidal anti?inflammatory drugs (NSAIDs) and prednisolone acetate in controlling inflammation and preventing cystoid macular edema (CME) after uneventful phacoemulsification. Methods: All patients who underwent uneventful phacoemulsification from December 2020 to Feb 2021 were included in the study. These were randomly assigned to receive any one anti?inflammatory agent among topical nepafenac (0.1%) [96 eyes], bromfenac (0.07%) [93 eyes], preservative?free ketorolac (0.4%) [94 eyes], nepafenac (0.3%) [96 eyes], or prednisolone acetate (1%) [91 eyes]. The efficacy of the drugs was evaluated by comparing the grade of anterior chamber (AC) cells, conjunctival hyperemia, pain score, visual acuity, intraocular pressure (IOP), and central macular thickness (CMT) at 1 and 6 weeks after surgery. Results: At 1 and 6 weeks, there was no significant difference in pain score, conjunctival hyperemia, AC cells, change in IOP, and visual acuity between the prednisolone and the NSAIDs groups, though nepafenac 0.3% was most effective. At 6 weeks, there was no significant difference in the number of patients developing subclinical CME in the prednisolone versus NSAID group. The mean increase in CMT was significantly lower in nepafenac 0.3% than prednisolone at 1 and 6 weeks (P = 0.003 and 0.004, respectively). Conclusion: NSAIDs used in isolation are comparable to prednisolone in preventing inflammation and pain after uneventful phacoemulsification. However, nepafenac 0.3% is most comparable to prednisolone and more efficacious in reducing the incidence of CME. We recommend that nepafenac 0.3% can be used as a sole anti?inflammatory agent in patients with uneventful phacoemulsification.

Development And Characterization Of Liposomal Formulation For Ophthalmic Delivery Of Prednisolone Acetate

Liposomal vesicular drug carriers for ocular delivery have earned a wide potential nowadays. Prednisolone Acetate liposome as ocular drug carriers have been demonstrated to be a useful mode to ameliorate bioavailability and patient abidance. Liposome was prepared by lipid extruder method. Liposome were characterized for entrapment efficiency (EE %), vesicle size, surface morphology and in vitro drug release. An ex vivo corneal permeation study was performed to determine the level of drug in the external eye tissue of goat and an ocular irritation assessment was done by Hen’s Egg Test - Chorioallantoic Membrane (HET-CAM) method. The optimized formulation of liposome had shown acceptable viscosity (1.21 ± 0.03 cps), refractive index (1.47±0.001), osmolarity (303 ± 3 mOsm) and pH measurement (7.12 ± 0.09). Liposome as drug delivery carriers were evidenced to be a anticipating impendent to enhance corneal contact and penetration as well as retention time in the eye ensuing in a prolonged action and enhanced bioavailability. The results of stability study exhibited stable profile of developed liposomes.

Comparison of Efficacy of Difluprednate Emulsion vs Topical Prednisolone Acetate on Post Phacoemulsification Inflammation

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.

Comparison between Intraarticular Triamcinolone Acetonide and Methyl prednisolone Acetate Injections in Treatment of Frozen Shoulder.

Background: This study is aimed to compare the effectiveness of intra-articular injections of 2 corticosteroid preparations; triamcinolone acetonide (40 mg) and methyl prednisolone acetate (40 mg) in patients with frozen shoulder. Methods: 100 patients were enrolled randomly in our study and randomly divided into two groups. Diagnosis of frozen shoulder was made using the guidelines for shoulder complaint issued by the Dutch College of General Practitioners. The assessment of pain was by using scores of; 0 (no pain); 1 (mild); 2 (moderate); 3 (severe); 4 (severe night pain that interferes with night sleep).The outcome of intervention was assessed at 8 weeks and after that at 3 months, at 6 months and at 1 year. Results: Right side was found to be more involved than the left. Male &Female ratio was 1:3. 51% patients belong to age group 55–65. We got 62.7% satisfactory result in Group A as compared to 51.8% in Group B. Conclusion: We conclude that triamcinolone acetonide is a good rescue for painful stiff shoulder particularly for resistant cases as with diabetes mellitus, and with long duration of illness.

Effects of Prednisolone and Loteprednol Eyedrops on the Proliferation of Human Tenon's Capsule Fibroblasts

PURPOSE: To compare the effect of loteprednol etabonate (LE) with prednisolone acetate (PDA) drops on the proliferation of human Tenon's capsule fibroblasts (HTFBs). METHODS: Primarily cultured HTFBs were treated with serially diluted PDA and LE for 3 days. Cellular survival was determined by a rapid colorimetric assay using MTT. RT-PCR was performed to determine the relative expression of TGF-beta mRNA in response to LE and PDA. RESULTS: PDA inhibited proliferation of HTCF in a dose-dependent manner and LE inhibited significantly the proliferation of HTCF at the higher concentration of 50 microg/ml (p < 0.05). Compared to LE, PDA inhibited proliferation of HTCF significantly at each diluted concentration (p < 0.05). Expressions of TGF-beta were decreased as the concentration of both PDA and LE increased. PDA decreased expression of TGF-beta more significantly compared to LE at each concentration (p < 0.05). CONCLUSIONS: Although LE has offered promising anti-inflammatory efficacy with decreased impact on intraocular pressure, LE may be less effective than PDA in inhibiting fibroblast proliferation and may be not comparable to PDA in preventing excessive scarring after glaucoma filtering surgery.

Comparación de la eficacia de la prednisolona y la rimexolona en el tratamiento de iridociclitis aguda en pacientes HLA-B27 positivos / Efficacy of prednisolone and rimexolone in HLA-B27 positive patients with acute anterior uveitis

Objetivo: Comparar la eficacia y seguridad de las suspensiones oftálmicas de acetato de prednisolona al 1% y de rimexolona al 1%, en el tratamiento de la uveítis anterior aguda (UAA) en pacientes HLA B27+. Material y métodos: Se seleccionaron al azar 68 pacientes con UAA HLA -B27+ para tratamiento con acetato de prednisolona al 1% o rimexolona al 1%. En todos los pacientes la inflamación en cámara anterior era leve a moderada. La presión intraocular (PIO) y el grado de inflamación fueron evaluados semanalmentre durante seis semanas. Fue un estudio clínico prospectivo, aleatorio y doble ciego. Resultados: Al cuantificar las células en cámara anterior no se encontraron diferencias estadísticamente significativas entre uno y otro grupos. En el grupo de rimexolona el flare disminuyó desde la primera semana. En los grupos la presión intraocular se elevó con respecto a la basal desde la primera semana, la variación fue más significativa en el grupo de rimexolona. La PIO final fue menor en el grupo de rimexolona, siendo esta diferencia estadísticamente significativa . Conclusión: Para el tratamiento de la UAA HLA -B27+, leve a moderada, la rimexolona al 1% y la prednisolona al 1% tiene una eficiencia similar. En este estudio las variaciones de presión intraocular en los dos grupos no fueron clínicamente significativas.

Purpose: To compare the efficacy and safety of prednisolone acetate 1 % vs. rimexolone 1 % ophthalmic suspension in the treatment of acute anterior uveitis (AAU) in HLA-B27+ patients. Methods: Sixty-eight AAU HLA-B27+ patients were randomly selected for treatment with prednisolone acetate 1% or Rimexolone 1%. All patients showed mild to moderate anterior chamber inflammation. This was a prospective, randomized, double blind, clinical trial. Results: There was no statistically significant difference between both groups when anterior chamber cells were measured. In the rimexolone group, flare diminished since the first week. In both groups the intraocular pressure (IOP) raised since the first week; the increase washighly significant in the rimexolone group. Final intraocular pressure was higher in the prednisolone group. Conclusion: Rimexolone 1 % is as effective as prednisolone acetate 1% in the treatment of mild to moderate AAU HLA B27+. IOP increased in both groups, but this variation was not clinically significant.

The Change of Corneal Endothelial Permeability and Corneal Thickness after Topical Steroid Treatment

Changes of corneal endothelial permeability and corneal thickness after instillation of topical steroid was evaluated. In five rabbits, 0.1%dexamethasone eye solution was dropped into right eyes, and in another five rabbits, 1%prednisolone acetate eye solution was dropped into right eyes, and each left eyes were used as a control with dropping of Tears Naturale(r)II (Alcon-couvreur, Belgium). After dropping eyedrops for seven days, corneal endothelial permeability and corneal thickness were measured. Mean corneal thickness changed from 371.4 micrometer to 334.2 micrometer after dropping eyedrops in 0.1%dexamethasone group, and from 375.8 micrometer to 347.8 micrometer in control group where no statistical difference was noted between the two groups. Corneal endothelial permeability was 3.58x10(-4)cm/min in 0.1%dexamethasone group, and 3.54x10(-4) cm/min in control group(p>0.05). Mean corneal thickness changed from 347.4 micrometer to 323.8 micrometer after dropping eyedrops in 1% prednisolone acetate group, and from 342.4 micrometer to 335.6 micrometer in control group. There was also no statistical difference between the two groups. Corneal endothelial permeability was 4.08x10(-4)cm/min in 1%prednisolone acetate group, and 4.26x10(-4) cm/min in control group(p>0.05). In conclusion, topical application of 0.1%dexamethasone or 1%prednisolone acetate for a short period may have no effect on corneal endothelial permeability and thickness.