A comparative study of the efficacy of preoperative loteprednol versus flurbiprofen in cataract surgery

Abstract

To evaluate the efficacy and cost-effectiveness of preoperative loteprednol versus flurbiprofen, when combined with moxifloxacin in maintaining intraoperative mydriasis and reducing postoperative complications. Materials and Methods: 200 cataract patients were divided into 2 groups. Group 1 receiving preoperative Flurbiprofen(0.03%) with moxifloxacin(0.5%) and Group 2 receiving Loteprednol(0.5%) with moxifloxacin(0.5%), three times a day 24 hrs prior to cataract surgery,followed by postoperative loteprednol(0.5%) and moxifloxacin(0.5%) in both groups. Intraoperative mydriasis and post operative complications were analysed. Patients were followed up on day 1, 1 week, 3 weeks and 7 weeks. Parameters evaluated included inflammation, pain, corneal edema, anterior chamber reaction (including cells and flare), intraocular pressure, CME. Results: Intraoperative mydriasis obtained in both the groups was comparable with no significant difference. Postoperative visual outcome was also comparable but postoperative inflammation was slightly more in Group 1 (p <0.05). Pain was more in group 1 on first postoperative day which was not statistically significant but this difference did not persist during further follow ups. 3 patients in group 1 and 2 patients in Group 2 developed CME on the last follow up which was not statistically significant. The rest of the parameters were comparable in the 2 groups with a much better compliance in group 2. Conclusion: This hospital based study in western Rajasthan revealed Loteprednol to be equally potent as flurbiprofen in maintaining intraoperative mydriasis along with significant reduction of postoperative complications while maintaining cost effectiveness and compliance as a single eye drop was used before and after surgery, with no steroid related complications.