Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used after cataract surgery to reduce inflammation and cystoid macular oedema (CMO). Diclofenac 0.1% is used three to five times daily for 28 days and Bromfenac 0.09% twice daily for 14 days postoperatively. The aim of the study was to compare efficacy and tolerability of the two agents (in adjunction to steroid-antibiotic combination) after routine cataract surgery. One hundred and thirty patients were included in this randomised controlled trial between 2014 and 2015. One hundred of these were split evenly into group 1 (Diclofenac) and group 2 (Bromfenac), while the remaining 30 (group 3) received no NSAIDs. Anterior chamber inflammation (measured using laser flare-cell photometry) was significantly higher in group 3 than the other two groups. It was also more significant with Bromfenac compared to Diclofenac. Central foveal thickness (CFT) on optical coherence tomography (OCT) was higher postoperatively compared to baseline, but this was more significant in the Bromfenac and control groups compared to the Diclofenac group. A higher proportion of patients complained of eye pain with Diclofenac compared to Bromfenac. The authors conclude that the addition of NSAIDs after cataract surgery reduced the inflammation and risk of CMO after cataract surgery. They demonstrated a higher efficacy with Diclofenac compared to Bromfenac. The latter, however, was better tolerated by patients and needed to be instilled only twice daily instead of four times.

The comparative efficacy and tolerability of Diclofenac 0.1% and Bromfenac 0.09% ophthalmic solutions after cataract surgery.
Giannaccare G, Finzi A, Sebastiani S, et al.
Kurt Spiteri Cornish

Sheffield Teaching Hospitals NHS Trust, London, UK.

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