title: Effect of topical ketorolac 0.4%, nepafenac 0.1%, and bromfenac 0.09% on postoperative inflammation using laser flare photometry in patients having phacoemulsification.
abstract: OBJECTIVE
  To study the effect of topical ketorolac 0.4% (Acular LS), bromfenac 0.09% (Megabrom), and nepafenac 0.1% (Nevanac) on postoperative inflammation using laser flare photometry in patients having phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation.
  
  
  METHODS
  Tertiary care center, Chandigarh, India.
  
  
  METHODS
  Prospective randomized case series.
  
  
  METHODS
  Patients with age-related cataract having phacoemulsification with PC IOL implantation were randomized into 4 groups receiving topical ketorolac 0.4% (Group A), bromfenac 0.09% (Group B), nepafenac 0.1% (Group C), or no nonsteroidal antiinflammatory drugs (NSAIDs) (Group D, control). The topical NSAIDs were started 1 day prior to the surgery and continued for 6 weeks postoperatively. All patients received a standard regimen of moxifloxacin 0.5% (Vigamox) and prednisolone acetate 1.0% (Pred Forte) eyedrops in tapering doses postoperatively. Visual acuity, intraocular pressure (IOP), laser flare photometry, and fundus examination were done preoperatively and postoperatively at 1 day and 1, 2, 4, and 8 weeks.
  
  
  RESULTS
  The study comprised 120 patients (120 eyes) (Group A = 33 patients, Group B = 30 patients, Group C = 31 patients, and Group D = 26 patients). The laser flare photometry values at the end of 4 weeks and 8 weeks were minimal in the nepafenac group compared with the other NSAID groups and the no-NSAID group (P = .032 at 4 weeks and P = .252 at 8 weeks).
  
  
  CONCLUSIONS
  The topical NSAIDs ketorolac 0.4%, bromfenac 0.09%, and nepafenac 0.1% were effective for the reduction of postoperative inflammation following phacoemulsification. Compared with ketorolac tromethamine, bromfenac, and the control, nepafenac was significantly effective 1 month postoperatively in reducing anterior chamber flare, as evidenced by decreased laser flare photometry.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sabin
authors.initials: S
authors.lastname: Sahu
authors.affiliation: From the Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: drjagatram@gmail.com.
authors.forename: Jagat
authors.initials: J
authors.lastname: Ram
authors.affiliation: From the Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Reema
authors.initials: R
authors.lastname: Bansal
authors.affiliation: From the Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Pandav
authors.affiliation: From the Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D044482:Benzeneacetamides / Q000008:administration & dosage / Q000627:therapeutic use; D001577:Benzophenones / Q000008:administration & dosage / Q000627:therapeutic use; D001969:Bromobenzenes / Q000008:administration & dosage / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D020910:Ketorolac / Q000008:administration & dosage / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D010648:Phenylacetates / Q000008:administration & dosage / Q000627:therapeutic use; D010783:Photometry / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D001577:Benzophenones; D001969:Bromobenzenes; D009883:Ophthalmic Solutions; D010648:Phenylacetates; C414203:nepafenac; C053083:bromfenac; D020910:Ketorolac