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P.J. Maris, Jr., H.D. Perry, E.D. Donnenfeld, T. Chou; Anesthesia and Ocular Tolerability of Topical Non–Steroidal Anti–Inflammatory Drugs: A Direct Comparison Between Bromfenac and Nepafenac . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4993.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the immediate and short–term anesthetic properties as well as the ocular tolerability of two commercially–available topical non–steroidal anti–inflammatory drugs (NSAIDs), bromfenac ophthalmic solution 0.9% (Xibrom, ISTA Pharmaceuticals, Irvine, CA) and nepafenac ophthalmic suspension 0.1% (Nevanac, Alcon Laboratories, Ft. Worth, TX).
20 subjects were administered one drop of bromfenac in one eye and a drop of nepafenac in the fellow eye. Cochet–Bonet esthesiometry of the central cornea was determined in each eye at baseline, then at 1–minute, 5–minutes, 10–minutes and 15–minutes following drop administration. Subjects also reported the subjective sensations of burning and stickiness on a scale of 0 – 10 in each eye immediately after drop administration. Inclusion criteria included the absence of active ocular surface pathology at the time of enrollment and a baseline esthesiometry measurement of 6.0 (full corneal sensation). Data were analyzed by Mann–Whitney U testing. A p–value of < 0.05 was considered statistically significant for all analyses.
The mean ± standard deviation (SD) age for the 20 subjects was 41.1 ± 14.3 years. Mean ± SD esthesiometry measurements in the bromfenac group and nepafenac group, respectively, were: 5.8 ± 0.3 and 5.9 ± 0.2 at 1–minute; 5.9 ± 0.2 and 5.9 ± 0.2 at 5–minutes; 6.0 ± 0.1 and 6.0 ± 0.0 at 10–minutes; and 6.0 ± 0.1 and 6.0 ± 0.0 at 15–minutes. The differences in esthesiometry measurements between the two groups were not statistically significant at any time point. The mean ± SD burning scores were 0.4 ± 0.8 in the bromfenac group and 0.3 ± 0.7 in the nepafenac group, and the differences between the groups did not reach statistical significance. The mean ± SD stickiness score was statistically significantly higher in the nepafenac group than in the bromfenac group: 2.9 ± 2.4 versus 0.7 ± 1.0.
When compared directly, the immediate and short–term anesthetic actions of bromfenac and nepafenac were not notably different. Nepafenac and bromfenac produced similar mild sensations of subjective burning. However, nepafenac produced considerably greater subjective stickiness when compared to bromfenac.
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