Dexamethasone Inserts Reduce Pain, Inflammation Prior to Cataract Surgery

Patients prefer dexamethasone inserts to topical steroid drops for reducing pain and inflammation after undergoing cataract surgery, according to research published in Clinical Ophthalmology. 

Researchers enrolled 30 participants (eyes, 60; 13 men; median age, 67 years) in the prospective analysis. All patients underwent bilateral cataract surgery and were prescribed topical moxifloxacin 0.5% 4 times a day for 1 week and topical bromfenac 0.07% once per day for a month. An optometrist placed a dexamethasone ophthalmic insert (0.4 mg) in 1 eye of each participant, while the contralateral eye served as a control. Control eyes received topical prednisolone acetate 1% 4 times per day for 1 week, 3 times per day for 1 week, 2 times per day for 1 week, and 1 time per day for 1 week.

All patients underwent biomicroscopy to assess mean anterior chamber cell and flare scores (sun score, 0-4). The visual analog scale was used to assess pain (0, no pain; 10, severe pain).

Overall, postsurgical anterior chamber cell scores were comparable between study and control eyes at day 1 (1.06 vs 1.15) and day 7 (0.25 vs 0.22). On day 30 following surgery, anterior chambers were quiet in 28 of 30 participants. The report shows no statistically significant differences in pain between study and control eyes (P =.92), and 23 patients reported a 0 rating for pain 1 day following surgery. Overall, 29 patients expressed a preference for dexamethasone inserts over the topical prednisolone acetate treatments.  

“The dexamethasone insert produced similar ocular comfort and inflammation prevention compared to prednisolone acetate eyedrops,” according to the researchers. “Dexamethasone inserts are a safe and effective treatment option for reducing pain and inflammation when inserted by an optometrist prior to routine cataract surgery.”

Study limitations include a small sample size. 

Disclosure: This research was supported by Ocular Therapeutix. Several study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures.