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Comparison of safety of loteprednol 0.5%/ difluprednate 0.05%/ prednisolone1% eye drops in the post cataract surgery patients

Preet Sood, Manmohan Bhanot, Narinder Singh.

Background: Post surgical ocular inflammation is a common happening after the cataract surgery. Topical steroids are the main stay of the treatment. Although it is quite effective in controlling it but it produces severe adverse drug reactions i.e. rise in intraocular pressure and dryness in the eyes. In present study we have compared the two newer topical steroids i.e. loteprednol and difluprednate with prednisolone for the safety issue.
Methods: Total n=150 patients of cataract were enrolled in the study. Institutional ethics committee approval was taken. After randomization, patients were allocated into three groups of 50 each. Baseline reading of intraocular pressure and tear film breakup time was recorded. Post operatively examination was done on day 7, 15 and 30 day. The results were compared as prednisolone versus loteprednol, prednisolone versus difluprednate.
Results: A. On intraocular pressure 1.prednisolone versus difluprednate statistically significant effect at day 7 (p=0.043), day15 (p=0.010) and at day 30(p=0.036) were there. 2. Prednisolone versus loteprednol- The difference was statistically highly significant at day 7 (0.00), day 15 (p=0.009) and at day 30th (p=0.00). B. On tear film breakup time-No significant effect on tear film breakup time is observed.
Conclusions: Both the newer drugs are much safer as compared to prednisolone for intraocular pressure. As they are equiefficacious to prednisolone their use in post cataract surgery inflammation is recommended.

Key words: Cortico steroid, Difluprednate, Intraocluar pressure, Loteprednol, Ocular inflammation, Tear film break up time

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