Compare the safety and efficacy of loteprendol etabonate 0.5% and prednisolone acetate 1% in the post operative inflammation following cataract extraction with intra ocular lens (IOL) implant
Keywords:
Inflammation, steroids, intraocular pressure, loteprednol, prednisolone
Abstract
Background: Inflammatory conditions represent one of the most common encountered clinical challenges in the ophthalmology. Topical steroids remain the cornerstone of ocular therapy. Loteprednol etabonate is a site-specific agent, approximates the efficacy of prednisolone acetate and has minimal effect on intraocular pressure (IOP). Limited studies have compared these two drugs, hence, it was considered worthwhile to compare loteprendol etabonate and prednisolone acetate in post operative inflammation following cataract extraction with IOL implant.Methodology: 30 patients operated for cataract extraction surgery with IOL implantation were studied for post operative inflammation and IOP changes, were divided into two groups. Group A received loteprednol etabonate and group B received prednisolone acetate. Cells in the anterior chamber (AC), flare were graded Signs of post operative inflammation including cells in anterior chamber (AC) and flare score were observed on day 1, 3, 8, 15 and 30. IOP was measured in each of these visits.Results: Both loteprdnol and prednisolone were equally efficacious in decreasing AC cells and flare but there was a statistically significant difference in the increase of IOP caused by both drugs. IOP increase of ≥10mm Hg was observed in patients receiving prednisolone. Conclusion: Both drugs were found to be highly effective in controlling post cataract extract inflammation with favourable safety profile. Loteprednol etabonate was found to have lesser propensity as compared to prednisolone acetate to increase IOP.References
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11. Stewart RS. Controlled evaluation of fluorometholone acetate and loteprednol etabonate in the treatment of postoperative inflammation following cataract surgery [abstract]. Investigative Ophthalmology and Visual Science 2004; 45(Suppl 1): U159
2. Amon M, Busin M. Loteprednol etabonate ophthalmic suspension 0.5%: efficacy and safety for post-inflammatory use. Int Ophthalmol 2012; 32: 507–17.
3. Pleyer U, Ursell PG, Rama P. Intraocular pressure effect of common topical steroids for post-cataract inflammation: Are they all the same. Ophthalmol Ther 2013; 2: 55-72.
4. Weber M, Kodijikian L, Kruse FE, Zagorski Z, Allaire CM. Efficacy and safety of indomethacin 0.1% eye drops compared with ketorolac 0.5% eye drop in the management of ocular inflammation after surgery. Acta Ophthalmol. 2013: 91: e15–21.
5. Hogan MJ, Kimura SJ, Thygeson P. Signs and symptoms of uveitis. I. Anterior uveitis. Am J Ophthalmol 1959; 47: 155-70.
6. Druzgala P, Hochhaus G, Bodor N. Soft drugs—10.Blanching activity and receptor binding affinity of a new type of glucocorticoid: loteprednol etabonate. J Steroid Biochem Mol Biol 1991; 38: 149–54.
7. Alberth M, Wu WM, Winwood D, Bodor N. Lipophilicity, solubility and permeability of loteprendnol etabonate: a novel, soft anti-inflammatory steroid. J Biopharm Sci 1991; 2: 115–25.
8. Grigorian RA, Shah A, Guo A. (2007) Comparison of loteprednol etabonate 0.5 % (Lotemax) to prednisolone acetate 1 % (Falcon) for inflammation treatment following cataract surgery [abstract]. Investigative Ophthalmology and Visual Science 2007; 48: 1065
9. Wei CJ, Ruili W, You L. The safety and efficacy of loteprednol etabonate on ocular inflammation: A Meta analysis. Clin Med J 2002; 115: 555-9.
10. Çoban P, Kocak Altintas AG. Comparison of the effect of loteprednol etabonate and prednisolone acetate on the intraocular pressure in uncomplicated phacoemulsification surgery. Turk Klin J Ophthalmol 2010; 19: 234–8.
11. Stewart RS. Controlled evaluation of fluorometholone acetate and loteprednol etabonate in the treatment of postoperative inflammation following cataract surgery [abstract]. Investigative Ophthalmology and Visual Science 2004; 45(Suppl 1): U159
Published
2015-11-12
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