The role of Dexamethasone in clinical pharmaceutical treatment for patients with cataract surgery

Abstract

Abstract. The aim of the present study is to determine the efficacy of dexamethasone (DEX) vs. indomethacin (IND) and ciprofloxacin (CIP) in modulating immediate inflammation following cataract surgery. A total of 644 patients with cataract were recruited and inflammation was investigated during the perioperative period. The management protocol was similar in both groups. Each drug was given four times a day for 30 days starting 7 days prior to surgery. The primary efficacy criteria for evaluation were the reduction in anterior chamber (AC) flare and AC inflammation score, in addition, a different secondary efficacy and safety evaluation criteria were maintained. The results demonstrated that the average inflammation score was 1.2±0.8 in the DEX group, which was significantly lower compared with the IND (1.9±0.7) and CIP (1.8±0.6) groups. Intra-ocular pressure was decreased following treatment with DEX, while intra-ocular pressure was slightly increased in the IND (1.9±0.7) and CIP (1.8±0.6) groups. The final visual outcomes for patients postcataract surgery were clinically superior in the DEX group compared with that of the IND and CIP groups (P=0.034 and P=0.042, respectively), but there was no significant difference between the ND and CIP groups (P= 0.78). Outcomes indicated that AC inflammation, conjunctival hyperaemia, corneal and lid oedema, ocular infection, pain, photophobia, and tearing were significantly improved in each group. No significant poor local tolerance or adverse reaction was observed in the DEX, IND and CIP groups. In conclusion, the outcomes of the present study suggest that DEX serves an important role in the clinical pharmaceutical treatment of patients with cataract surgery.

Intracameral Versus Sub-conjunctival Dexamethasone Injection for Postoperative Inflammation in Congenital Cataract Surgery

“…The study by Zhang et al demonstrated that the average inflammation score was significantly lower in Dexamethasone group compared with the Indomethacin and Ciprofloxacin groups. Moreover, they also witnessed decreased intra-ocular pressure with Dexamethasone compared to other study interventions 22 .…”

Simultaneous co-delivery of neuroprotective drugs from multi-loaded PLGA microspheres for the treatment of glaucoma

“…The present study describes a MSs formulation incorporating three established therapies with anti-inflammatory and neuroprotective activity; dexamethasone, melatonin and coenzyme Q10. The corticosteroid dexamethasone (DX) is commonly used in the treatment of ocular inflammation in conditions such as diabetic macular edema, central retinal vein occlusion, and uveitis [25][26][27]. Melatonin (MEL) is an antioxidant with free radical scavenging and neuroprotective activity mediated via multiple mechanisms including the inhibition of the mitochondrial transition pore, reducing NO-induced apoptosis or reducing excitotoxicity Ca 2+ overload [28][29][30][31].…”

Use of Human Pluripotent Stem Cells to Define Initiating Molecular Mechanisms of Cataract for Anti-Cataract Drug Discovery

“…Currently, used drugs that have primary cataract as a side-effect might be the simplest cataract risk factors to investigate, due to the ease in which they can be added to culture media over a range of clinically relevant concentrations. For example, dexamethasone is routinely prescribed to treat a variety of disorders, such as rheumatoid arthritis [80], ocular inflammation [81], and post-surgical inflammation [82,83]. Notably, long-term use of dexamethasone has been associated with posterior subcapsular cataract [84,85,86].…”