Comparison of Efficacy of Difluprednate 0.05% and Loteprednol Gel 0.5% After Cataract Surgery

Monday, April 20, 2015: 3:21 PM
Room 1B (San Diego Convention Center)
Bryan Abessi, MD
Robert L. Schultze, MD
Robert A. Eden, MD
Lauren M. Brooksby

To compare the efficacy of topical difluprednate 0.05% and loteprednol Gel 0.5% in reducing inflammation and aiding visual recovery after phacoemulsification cataract surgery in healthy patients, as well as evaluate their secondary effects on intraocular pressure (IOP), corneal edema, and corneal surface changes (dry eye).

Prospective cohort in 60 eyes undergoing cataract surgery randomized into two groups: Group A (n=30) receiving difluprednate; Group B (n=30) receiving loteprednol. Patients with vision-compromising ocular pathology and/or pre-operative IOP >21 were excluded. All patients were to take the medication four times daily for one week post-operative, then two times daily for one week. Visual acuity, IOP, cell grade, corneal edema, lissamine staining, and tear film osmolarity were evaluated during the four study visits: pre-operative, 1 day, 1 week, and 1-month post-operative. Statistical analysis was preformed using two-tailed t-tests to compare means and two-sample z-test to compare proportions.

Pre-operative values of each parameter were similar in Group A (n=30) and Group B (n=30) and not statistically significant (p>0.05), except for tear film osmolarity (p=0.047).  Both groups had similar cell grade at each follow-up visit (p>0.05). Both groups achieved a mean visual acuity of at least 20/25 (in negative log units) by one-week post-operative (0.055 and 0.061, respectively; p>0.05), and sustained that visual acuity into their one-month post-operative visit (0.049 and 0.035, respectively; p>0.05). Corneal edema, IOP, lissamine staining, and tear film osmolarity were also similar between the two groups at each follow-up visit (p>0.05).

Both treatments of topical difluprednate 0.05% and loteprednol gel 0.5% are equally effective in reducing inflammation after phacoemulsification cataract surgery, and both had a similar effect on post-operative visual recovery.  Our data also indicates that the steroid effect on IOP between the two treatments is equivalent.