Comparative Effectiveness of 0.1% Dexamethasone Sodium Phosphate + 0.5% Neomycin Sulfate versus 1% Prednisolone Acetate Eye Drops in Postoperative Inflammation after Cataract Surgery at Krabi Hospital
Article Sidebar
Main Article Content
Abstract
Objective: This study aimed to compare the efficacy of 0.1% Dexamethasone Sodium Phosphate combined
with 0.5% Neomycin Sulfate (DexOph®) and 1% Prednisolone Acetate (Pred Forte®) in controlling
postoperative anterior chamber inflammation following cataract surgery at Krabi Hospital.
Methods: This retrospective study reviewed medical records of 160 patients who underwent
phacoemulsification with intraocular lens implantation. Patients were divided into the DexOph® group
(n = 88) and the Pred Forte® group (n = 72). Postoperative outcomes were assessed in terms of anterior
chamber inflammation (using the SUN grading system), visual acuity (VA), and intraocular pressure (IOP) at
days 7–10 and 30–42 after surgery.
Results: There were no statistically significant differences between the two groups in VA, IOP, corneal
condition, or anterior chamber inflammation at any follow-up time points. Although the DexOph® group
had a higher proportion of patients with hypertension and demonstrated significantly different initial
postoperative anterior chamber inflammation, multivariable analysis identified initial cell grade 4 on the first
postoperative day (aOR = 6.00, 95% CI: 1.59–22.67, p = 0.008) as an independent risk factor for persistent
inflammation on days 7–10 post-surgery. Subgroup analysis suggested a trend toward greater efficacy of 1%
Prednisolone Acetate in patients with grade 3 inflammation on the first postoperative day (p = 0.054).
Conclusion: Both 0.1% Dexamethasone Sodium Phosphate with 0.5% Neomycin Sulfate and 1%
Prednisolone Acetate demonstrated comparable overall efficacy in reducing postoperative inflammation
after cataract surgery. However, individual clinical factors—particularly the degree of initial postoperative
inflammation—should be considered when selecting the optimal treatment to achieve personalized and
effective anti-inflammatory management.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความนิพนธ์ต้นฉบับจะต้องผ่านการพิจารณาโดยผู้ทรงคุณวุฒิที่เชี่ยวชาญอย่างน้อย 2 ท่าน แบบผู้ทรงคุณวุฒิ และผู้แต่งไม่ทราบชื่อกันและกัน (double-blind review) และการตีพิมพ์บทความซ้ำต้องได้รับการอนุญาตจากกองบรรณาธิการเป็นลายลักษณ์อักษร
ลิขสิทธิ์
ห้ามนำข้อความทั้งหมดหรือบางส่วนไปพิมพ์ เว้นว่าได้รับอนุญาตจากโรงพยาบาลเป็นลายลักษณ์อักษร
ความรับผิดชอบ
เนื้อหาต้นฉบับที่ปรากฏในวารสารเป็นความรับผิดชอบของผู้เขียน ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากเทคนิคการพิมพ์
References
เอกสารอ้างอิงอ้างอิง
Malik A,et al.A comparative study of various topical NSAIDs to steroid drops for control of post cataract surgery inflammation.Oman J Ophthalmol.2016 Sep Dec;9(3):150-156
The royal college of Ophthalmologists, Cataract surgery guidelines. Scientific department, The Royal college of Ophthalmologists, London, 2004
Oshika T, Yoshimura K, Miyata N. Postsurgical inflammation after phacoemulsification and extracapsular extraction with soft or conventional intraocular lens implantation. J Cataract Refract Surg1992; 18:356±61.
Laurell CG, Zetterström C, Philipson B, et al. Randomized study of the blood-aqueous barrier reaction after phacoemulsification and extracapsular cataract extraction. Acta Ophthalmol Scand 1998;76:573±8.
Pande MV, Spalton DJ, Kerr-Muir MG, et al. Postoperative inflammatory response to phacoemulsification and extracapsular cataract surgery: aqueous flare and cells. J Cataract Refract Surg 1996;22(suppl):770±4.
Smith S, Lorenz D, Peace J, McLeod K, Crockett RS, Vogel R. Difluprednate ophthalmic emulsion 0.05% (Durezol) administered two times daily for managing ocular inflammation and pain following cataract surgery. Clin Ophthalmol. 2010;7(4):983-991.
Foster CS, Alter G, DeBarge LR, et al. Efficacy and safety of rimexolone 1% ophthalmic suspension vs 1% prednisolone acetate in the treatment of uveitis. Am J Ophthalmol. 1996;122(2):171-182.
Reddy R, Patil A. Comparative study of efficacy of topical dexamethasone 0.1% with difluprednate 0.05% in post-operative small incision cataract surgery. Indian J Clin Exp Ophthalmol. 2018;4(3):339–46.
S. Bhartiya, Sunita Singh, Sudeep Sabbithi. Comparative study of the anti inflammatory effect of topical 1% prednisolone and topical 0.1% dexamethasone eyedrops after cataract surgery in western Uttar Prades. International journal of contemporary surgery (vol no:2) 2013
D Chandrakanth Reddy, Kausika Garapati. Comparative efficacy of topical corticosteroids in the post-operative management of cataract surgery. International Journal of Ophthalmology. November 2019; 12(2): 25-30
Chatziralli IP,Papazisis L, Sergentanis TN. Ketorolac plus tobramycin/dex amethasone versus tobramycin/dexamethasone after uneventful phacoemul sification surgery: a randomized controlled trial. Ophthalmologica 2011; 225:89–94
Pei-Qing Chen,Xue-Mei,Ya-Nan Zhu,Jia Xu.Comparison of the anti-inflammatory effects of fluorometholone 0.1% combined with levofloxacin 0.5% and tobramycin/dexamethasone eye drops after cataract Int J Ophthalmol 2016 Nov 18;9(11)
Diestelhorst M, Aspacher F, Konen W, Krieglstein GK, Hilgers RD. Effect of dexamethasone 0.1% and prednisolone acetate 1.0% eye drops on the blood–aqueous barrier after cataract surgery: a controlled randomized fluorophotometric study. Graefes Arch Clin Exp Ophthalmol. 1992;230(5):451–453.
Russo S, Delcassi L, Nanni O, et al. Dexamethasone–netilmicin: efficacy and safety after cataract surgery. Eye. 2007;21(1):58–64.
Juthani VV, Clearfield E, Chuck RS. Non-steroidal anti-inflammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery. Cochrane Database Syst Rev. 2017;7:CD010516
