Effectiveness and tolerance of piroxicam 0.5% and diclofenac sodium 0.1% in controlling inflammation after cataract surgery.
OBJECTIVE
To compare the efficacy and tolerance of piroxicam 0.5% ophthalmic solution and diclofenac sodium 0.1% ophthalmic solution in controlling inflammation after phacoemulsification and intraocular lens (IOL) implantation.


METHODS
Ophthalmological Department, San Donà di Piave Hospital, Venice, Italy.


METHODS
Forty consecutive patients--18 men and 22 women--between 55 and 85 years of age (mean age, 75.1 +/- 7.12 years) who were scheduled for cataract extraction with phacoemulsification and IOL implantation were randomized to receive 0.5% piroxicam ophthalmic solution (piroxicam group, 20 patients) or 0.1% diclofenac sodium ophthalmic solution (diclofenac group, 20 patients) for 1 month postoperatively. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) measurements and slit-lamp biomicroscopy for the evaluation of corneal edema, Descemet membrane folds, Tyndall, and cells in the anterior chamber were carried out in all patients 1 day, 4 days, and 1 month postoperatively. Subjective symptoms after the nonsteroidal anti-inflammatory drug (NSAID) ophthalmic solution instillation were assessed using a questionnaire.


RESULTS
There were no significant differences between the two groups in postoperative IOP, BCVA, anterior chamber flare and cell levels, corneal edema, or Descemet membrane folds. Ocular discomfort, evaluated as burning or stinging sensation after NSAID ophthalmic solution instillation, was significantly more frequent and intense in the diclofenac-treated eyes. Two eyes in the diclofenac group had a mild transient punctate keratitis.


CONCLUSIONS
These results suggest that piroxicam is as effective as diclofenac sodium in preventing inflammation after cataract surgery with IOL implantation, and its better tolerance and safety can provide higher patient compliance.
Scuderi
B
B
Department of Ophthalmology, Hospital of San Donà di Piave, Venezia, Italy.
Driussi
G B
GB
Chizzolini
M
M
Salvetat
M L
ML
Beltrame
G
G
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D004008:Diclofenac / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D018918:Phacoemulsification; D010894:Piroxicam / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000517:prevention & control*; D014792:Visual Acuity
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D010894:Piroxicam; D004008:Diclofenac