Choice of diclofenac or corticosteroids for strabismus surgery
Reviewed by Fiona Rowe

This systematic review was undertaken to analyse the available data on various corticosteroids and diclofenac to determine the most effective postoperative anti-inflammatory agent for patients with strabismus. Twenty-five studies were identified from 1997–2021 and a total of eight met the inclusion criteria; seven randomised control trials (RCTs) and one cohort study with a total sample size of 469 eyes of 417 patients. Diclofenac had a statistically significant improvement in discomfort, conjunctival chemosis, conjunctival inflammation and intraocular pressure, in comparison to corticosteroids, at two weeks postoperative, but not at one week. Significant differences were also found for conjunctival gap at one, two and four weeks postoperative. Diclofenac showed significantly less conjunctival injection and congestions at weeks one and two. There was no significant differences for discharge and drop intolerance. The results suggest that Diclofenac is comparable to various corticosteroids for use in strabismus surgery and for some outcomes, yielded significant improvements, mainly at two weeks postoperative.

Diclofenac versus corticosteroids following strabismus surgery: systematic review and meta-analysis.
Karam M, Alsalf A, Al-Naseem A, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60:312–22.