First Author: N.Borah INDIA
Co Author(s): S. Buragohain
Purpose:
to study effectiveness of Bromfenac eye drop(0.09%) and Prednisolone acetate eye drop while reducing post operative ocular pain and inflammation following phacoemulsification with foldable intraocular lens implantation surgery(phaco +FIOL) in Indomongoloids.
Setting:
Comparative study is lacking between bromfenac eye drop and prednisolone acetate eye drop as primary medication following phaco +FIOL in Indomongoloids(ethnic groups from India identified as Mongoloid).Twice daily or once daily dosing of Bromfenac may increase drug compliance in elderly patients.
Methods:
107 eyes(107 patients) were studied prospectively between September, 2011 to December, 2011. Following phaco +FIOL patients were randomly selected to receive Bromfenac eye drop (53 eyes) or Prednisolone acetate eye drop(54 eyes) for a period of 21 days. Pre- and post operative BCVA, slit lamp examination, IOP, and dilated fundus examinations were done. Follow up-1st day, 3rd day,7th day,21st day.
Inclusion criteria: uncomplicated phaco +FIOL(SA60AT, ALCON lab, Ireland).Exclusion criteria: history of uveitis , diabetes mellitus, trauma, irregular follow up.
Post-operatively Bromfenac eye drop was instilled 2 times/day for 21 days and Prednisolone acetate eye drop was instilled 6 times/day on 1st day then gradually tapered till 21st day. Post- operative pain score was recorded in both groups. During post-operative examinations investigators were masked about the medications received by the patients.
Results:
total 107 patients (107 eyes) were studied. Mean age of male and female patients in Bromfenac group was 61.5 years(SD ± 5.54) and of Prednisolone acetate group 60.45 years (SD ± ,6.87). Eyes receiving Bromfenac eye drop reported less pain on the 1st post-operative day. FisherÂ’s exact test- relative risk 0.687(CI, 0.519-0.90). P value was significant(<0.0075).However, pain scores on 7th post-operative day in both the groups were similar. Relative risk 3.7(CI, 1.10-12.64).P < 0.235. Anterior chamber inflammation (anterior chamber cells and flare) on 1st post operative day was similar in both the groups. Relative risk 1.075 (CI, 0.638 -1.812). P< 0.840. However, on 7th post-operative day AC cells and flare were significantly higher in eyes receiving Bromfenac eye drop. Relative risk 3.311(CI, 1.960 -5.595). P < 0.001.On 21st day pain and AC inflammation were absent in both the groups. In 14 eyes(26.42%) in Bromfenac group ocular irritation and conjuctival injection was noted on 21st post-operative day.
Conclusions:
the eyes that received Bromfenac eye drop following phacoemulsification with FIOL implantation, pain was significantly lower (P<0.0075) than the eyes receiving prednisolone acetate eye drop. However, on subsequent days(3rd ,7th and 21st ) post-operative pain was similar in both the groups in this study. Although post-operative inflammation was similar in both the groups on 1st day eyes receiving prednisolone acetate eye drop recovered more rapidly (P<0.001). Bromfenac eye drop in twice daily dosing increases drug compliance in elderly patients. In this series in Indomongoloid population comparatively increased incidence of conjuctival injection and ocular irritation was found in Bromfenac group. We recommend further study on allergic reaction to Bromfenac eye drop in this population. FINANCIAL DISCLOSURE?: No
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