Topical Nonsteroidal Anti-inflammatory Drugs and Cataract Surgery

Kim, Stephen J.; Schoenberger, Scott D.; Thorne, Jennifer E.; Ehlers, Justis P.; Yeh, Steven; Bakri, Sophie J.

doi:10.1016/j.ophtha.2015.05.014

Cited by 131 publications

(105 citation statements)

References 37 publications

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“…In fact, the postoperative regime of patients that underwent cataract extraction aims primarily in preventing endophthalmitis, persistent corneal edema and cystoid macular edema [8, 9]. However, apart from these complications, a series of non-vision-threatening adverse events have been identified that cause great discomfort and frustration to the patient, like pain, foreign body sensation, and itchiness.…”

Section: Introductionmentioning

confidence: 99%

Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study

et al. 2017

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BackgroundUniversal postoperative guidelines for cataract extraction surgery are yet to be introduced. Artificial tears are gaining popularity as an additional integral component of the postoperative regime. The primary objective of this study was to explore the impact of two prevalent artificial tear preparations on postoperative discomfort following cataract extraction surgery.MethodsA total of 180 patients that underwent cataract extraction surgery were randomly divided into three groups according to their postoperative regime: a) Study group 1 (SG1) received a fixed combination of tobramycin and dexamethasone (FCTD) quid for 3 weeks and, additionally polyethylene glycol 400/propylene glycol/hydroxypropyl-guar quid, for 6 weeks, b) Study group 2 (SG2) received FCTD quid for 3 weeks and, additionally 0.1% sodium hyaluronate provided in the COMOD® device quid, for 6 weeks, and, c) Control Group (CG) received only FCTD quid for 3 weeks. The following indexes were evaluated at three postoperative checkpoints: 1) Subjective discomfort index (SDI) derived from four direct 10-scale Likert-type questions that were addressed to the patient and pertained to: a) foreign body sensation (FBS), b) blinking discomfort (BD), c) stinging sensation (SS), d) tearing sensation (TS), 2) Tear break-up time (TBUT), 3) Central corneal thickness (CCT) and, 4) Central Corneal Sensitivity (CCS).ResultsBoth groups showed increased CCT values at the first examination point and reduced CCS values at all examination points. Furthermore, both SGs had better TBUT times at all examination points compared to CG (CG: 8.86 ± 1.08, SG1: 9.59 ± 1.45, CG2: 9.45 ± 1.33, p < 0.05). BD was significantly better in both SGs only at the 1st week of examination, while SDI values were better until the 3rd week and only borderline better at 6th week. Lastly, no significant differences were detected between SGs, regarding all parameters, at all examination points.ConclusionPolyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate provided in the COMOD® device seem to be equally efficient in alleviating OSD symptoms following cataract extraction surgery and any of them should be routinely added to the postoperative regime.Trial registrationClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02558218NCT02558218Electronic supplementary materialThe online version of this article (doi:10.1186/s40662-017-0079-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study

et al. 2017

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“…Lowering the pH of these formulations increases corneal penetration but also increases potential irritation. Additionally, it has been reported that due to the anionic nature of NSAIDs, they are incompatible with preservatives such as benzalkonium chloride and could form insoluble complexes [29–31]. IN (pKa of 4.5) exhibits pH-dependent solubility, which increases as a function of higher pH (acidic to neutral/alkaline: 1.5 µg/mL at pH 1.2 and 105.2 µg/mL at pH 7.4).…”

Section: Discussionmentioning

confidence: 99%

Topical ophthalmic lipid nanoparticle formulations (SLN, NLC) of indomethacin for delivery to the posterior segment ocular tissues

Balguri

Adelli

Majumdar

2016

European Journal of Pharmaceutics and Biopharmaceutics

142

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Purpose The objective of the present study was to formulate indomethacin (IN)-loaded solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) and to investigate their potential use in topical ocular delivery. Methods IN SLNs (0.1% w/v) and NLCs (0.8% w/v) were prepared, characterized and evaluated. Their in vitro release and flux profiles across the cornea and sclera-choroid-RPE (trans-SCR) tissues and in vivo ocular tissue distribution were assessed. Furthermore, chitosan chloride (CS) (mol. wt. < 200 kDa), a cationic and water-soluble penetration enhancer, was used to modify the surface of the SLNs, and its effect was investigated through in vitro transmembrane penetration and in vivo distribution tissue studies. Results For the IN-SLNs, IN-CS-SLNs and IN-NLCs, the particle size was 226 ± 5, 265 ± 8, and 227 ± 11 nm, respectively; the zeta potential was −22 ± 0.8, 27 ± 1.2, and −12.2 ± 2.3 mV, respectively; the polydispersity index (PDI) was 0.17, 0.30, and 0.23, respectively; and the entrapment efficiency (EE) was 81 ± 0.9, 91.5 ± 3.2 and 99.8 ± 0.2%, respectively. The surface modification of the SLNs with CS increased the ocular penetration of IN. The NLCs maintained significantly higher IN concentrations in all ocular tissues tested compared to the other formulations evaluated in vivo. Conclusion The results suggest that lipid-based particulate systems can serve as viable vehicles for ocular delivery. The NLC formulations demonstrated increased drug loading capability, entrapment and delivery to anterior and posterior segment ocular tissues.

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“…The application of topical NSAIDs is indicated for immediate postoperative inflammation and pain in the setting of cataract surgery, the maintenance of the mydriasis during cataract surgery, and the management of cystoid macular edema particularly following cataract surgery. Perioperative NSAIDs are frequently given, with the use of these agents for up to a month after surgery in uncomplicated cases (Kim et al 2015). Topical NSAIDs are used in a more limited basis following corneal abrasion or photorefractive keratectomy, however care must be taken not to experience the untoward side effects of delayed wound healing and corneal toxicity.…”

Section: Nonsteroidal Anti-inflammatory Drugs (Nsaids)mentioning

confidence: 99%

Anti-Infective and Anti-Inflammatory Pharmacotherapies

Rosenblatt

2017

Handbook of Experimental Pharmacology

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Ocular infection and inflammation are common and are associated with myriad ocular conditions ranging from mild disease to blinding conditions. There are numerous anti-invectives with spectra against inciting pathogens. Given the potential for ocular infections to rapidly progress initial broad spectrum therapy is usually required, with therapy tailored as microbiological identification and sensitivities become available. The emergence of antibiotic resistance has become a major health problem. Anti-inflammatory therapy can be institutes to prevent ocular symptoms and end-organ damage. A therapy should be selected which is potent enough to interrupt the inflammatory cascades in play, but which avoids potential side effects. Glucocorticoids, NSAIDs, and biological agents may be used singularly or in combination. New drug delivery devices may allow for better local treatment of chronic ocular inflammation.

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Topical Nonsteroidal Anti-inflammatory Drugs and Cataract Surgery

Cited by 131 publications

References 37 publications

Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study

Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study

Topical ophthalmic lipid nanoparticle formulations (SLN, NLC) of indomethacin for delivery to the posterior segment ocular tissues

Anti-Infective and Anti-Inflammatory Pharmacotherapies

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