Incidence of Steroid-Induced Ocular Hypertension After Vitreoretinal Surgery With Difluprednate Versus Prednisolone Acetate

Jeng, Karen W; Fine, Howard F; Wheatley, H. Matthew; Roth, Daniel B.; Connors, Daniel B.; Prenner, Jonathan L.

doi:10.1097/iae.0000000000000215

Cited by 16 publications

(12 citation statements)

References 7 publications

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“…The data from this study confirmed earlier reports showing an increase in IOP when DFBA is compared to PA 25,28,30. Importantly, in this study, the mean IOP remained ≤21 mmHg for both PA and DFBA patients.…”

Section: Discussionsupporting

confidence: 91%

“…Jeng et al conducted a retrospective chart review of 100 patients treated with either PA or DFBA after vitreoretinal surgery where patients received PA or DFBA four times a day for a minimum of 1 month. Similar to this present study, the authors found that compared to PA-treated patients, DFBA-treated patients had a significantly higher percentage of patients with an IOP of ≥21 mmHg and an increase from baseline of >10 mmHg 28. The percentages were higher in the study conducted by Jeng et al possibly related to the higher steroid dosage used (four times a day for 1 month).…”

Section: Discussionsupporting

confidence: 86%

“…Finally, proportions of patients were ascertained for the aforementioned categories if the patients’ IOP measured ≥21 mmHg and exhibited increases of IOP of ≥10 mmHg at TP1. These values were chosen based on previously published studies and seemed both most rigorous in the definition of steroid response as well as clinically significant 2,28,30. Fisher’s exact test was assessed to evaluate any relationship between the proportions of clinical significant increases of IOP and potential risk factors (age, glaucoma, and diabetes).…”

Section: Methodsmentioning

confidence: 99%

“…While studies have compared DFBA versus PA for vitreoretinal surgery28,29 and anterior uveitis,21,30 few have investigated IOP increase with the use of these drugs in the context of cataract surgery 2,24. Here, the results of a large (n=4,184) retrospective study evaluating the potential for corticosteroid-induced ocular hypertension with the use of either PA (n=2,151) or DFBA (n=1,337) in post-cataract surgery patients are reported.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Kusne

Kang

Fintelmann

2016

OPTH

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PurposeTo compare the effect of topical prednisolone acetate 1% (PA) used after routine cataract surgery to the effect of difluprednate 0.05% (DFBA) used for the same indication on intraocular pressure (IOP).MethodsAn electronic query was created to gather information from all cataract surgeries between January 2010 and January 2015 within the electronic health record database at Barnet Dulaney Perkins, a multicenter, multiphysician private practice in Phoenix, Arizona. Information collected included age, sex, diabetes status, glaucoma history, medication regimen (use of PA or DFBA), and IOP before surgery, 5–10 days postoperatively (TP1) and 3–6 weeks postoperatively (TP2). Postoperative IOP measurements were compared to baseline IOP measurement in each patient.ResultsRegardless of steroid used, all patients in this study experienced an increase in IOP within TP1 and returned to baseline IOP (±2.0 mmHg) by TP2. Patients who received DFBA showed a statistically significant increase in IOP at TP1 compared to those on PA (P<0.001) with the mean IOP an average 0.60 mmHg higher (95% CI =0.3, 0.9). The odds ratio of a clinically significantly increased IOP at TP1 (defined as overall IOP ≥21 mmHg and an increase of ≥10 mmHg) in DFBA-treated patients was 1.84 (95% CI =1.4, 2.6). In patients treated with PA, 3% reached a significantly increased IOP, compared to 4.4% of patients in the DFBA group (P<0.05). Risk factors for increased IOP were identified, and include advanced age (>75) (P<0.005) and a history of glaucoma (P<0.001).ConclusionIn postoperative cataract patients, use of DFBA increased the risk of a clinically significant IOP increase.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Kusne

Kang

Fintelmann

2016

OPTH

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“…20,21 Elevated IOP is a known potential adverse reaction to steroid use, 22 and is listed in the warnings section of the package insert for this drug class. Based upon previous experience with topical ocular steroids, class labelling, and the characteristics of the patient population in the current study, the incidence of increased IOP is not unexpected.…”

Section: Discussionmentioning

confidence: 99%

Difluprednate versus prednisolone acetate for inflammation following cataract surgery in pediatric patients: a randomized safety and efficacy study

Wilson

Lambert

Plager

et al. 2016

Eye

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Purpose To evaluate safety and efficacy of difluprednate 0.05% ophthalmic emulsion for treatment of postoperative inflammation after cataract surgery in pediatric patients. Methods This was a phase 3B, multicentre, randomized, double-masked, active-controlled study of patients aged 0-3 years who underwent uncomplicated cataract surgery in one eye, with/without intraocular lens implantation. Patients were randomized to receive difluprednate 0.05% four times daily or prednisolone acetate 1% for 14 days post surgery, followed by tapering for 14 days. Safety included evaluation of adverse events. Primary efficacy was the proportion of patients with an anterior cell grade of 0 (no cells) at day 14; secondary efficacy was a global inflammation score. Results Forty patients were randomized to each treatment group. Adverse drug reactions included corneal oedema (difluprednate 0.5%, n = 1; prednisolone acetate 1%, n = 0) and increased intraocular pressure or ocular hypertension (n = 2/group). Mean intraocular pressure values during treatment were 2-3 mm Hg higher with difluprednate 0.05% compared with prednisolone acetate 1%; mean values were similar between groups by the first week after treatment cessation. At 2 weeks post surgery, the incidence of complete clearing of anterior chamber cells was similar between groups (difluprednate 0.05%, n = 30 (78.9%); prednisolone acetate 1%, n = 31 (77.5%)). Compared with prednisolone acetate 1%, approximately twice as many difluprednate 0.05%-treated patients had a global inflammation assessment score indicating no inflammation on day 1 (n = 12 (30.8%) vs n = 7 (17.5%)) and day 8 (n = 18 (48.7%) vs n = 10 (25.0%)). Conclusions Difluprednate 0.05% four times daily showed safety and efficacy profiles similar to prednisolone acetate 1% four times daily in children 0-3 years undergoing cataract surgery.

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Corticosteroid-Induced Glaucoma

Liu

Arrigg

2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Incidence of Steroid-Induced Ocular Hypertension After Vitreoretinal Surgery With Difluprednate Versus Prednisolone Acetate

Abstract: Eyes treated with DP after vitreoretinal surgery were at increased risk for developing clinically significant increases in IOP compared with those receiving PA.

Cited by 16 publications

References 7 publications

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Difluprednate versus prednisolone acetate for inflammation following cataract surgery in pediatric patients: a randomized safety and efficacy study

Corticosteroid-Induced Glaucoma

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