June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Safety and Efficacy of 0.1% Nepafenac versus 1% Prednisolone acetate Eye Drops after Laser Iridotomy - A Prospective, Randomized Trial
Author Affiliations & Notes
  • kavitha srinivasan
    Glaucoma, Aravind Eye Hospital, Pondicherry, Pondicherry, India
  • Keerthi Gayam
    Glaucoma, Aravind Eye Hospital, Pondicherry, Pondicherry, India
  • Swati Upadhyaya
    Glaucoma, Aravind Eye Hospital, Pondicherry, Pondicherry, India
  • Rengaraj Venkatesh
    Glaucoma, Aravind Eye Hospital, Pondicherry, Pondicherry, India
  • Pradeep Ramulu
    Wilmer Eye Institute, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   kavitha srinivasan, None; Keerthi Gayam, None; Swati Upadhyaya, None; Rengaraj Venkatesh, None; Pradeep Ramulu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2459. doi:
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      kavitha srinivasan, Keerthi Gayam, Swati Upadhyaya, Rengaraj Venkatesh, Pradeep Ramulu; Safety and Efficacy of 0.1% Nepafenac versus 1% Prednisolone acetate Eye Drops after Laser Iridotomy - A Prospective, Randomized Trial. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2459.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Steroid abuse is very common in developing countries like India because of easy availability and low cost. Here we compared the safety and efficacy of 0.1% Nepafenac, a topical nonsteroidal anti-inflammatory drop, with 1% Prednisolone acetate in controlling inflammation after YAG laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS)

Methods : We randomized 152 PACS aged 40-70 years undergoing bilateral LPI to 0.1% Nepafenac or 1% Prednisolone eye drop in both eyes after LPI. Medications were given 4 times daily for 7 days and then twice daily for an additional 7 days. Investigators and patients were masked to the type of medication issued. Outcome measures were the degree of anterior chamber (AC) cell, flare on slit-lamp biomicroscopy using standardized uveitis nomenclature grading and changes in intraocular pressure (IOP) measured with Goldmann applanation tonometry. Postoperative assessments were completed at 2 and 4 weeks

Results : Study groups were comparable in terms of age, gender, comorbid illness, baseline IOP and total laser energy (p>0.6 for all). One patient in Nepafenac group had 1+ cells at 2 wks; at 4 wks eyes were quiet in both groups. Within 2 days of stopping eye drop rebound iritis was seen in 4 patients in Prednisolone group, which subsided at 4 wks with additional medication, but it was not seen with any Nepafenac treated patients (p=0.037). IOP differences from baseline to 2 wks were significantly higher in Prednisolone group than the Nepafenac group (+2.8 vs +0.5 mm Hg; p=0.003), though at 4 wks IOPs were not significantly different than baseline in either group (p>0.1 for both), and did not differ between the 2 groups (+0.56 vs +0.18 mm Hg in Prednisolone and Nepafenac groups respectively, p=0.499). By 2 wks 6-15 mm Hg IOP elevation from baseline was seen in 3 subjects in Nepafenac,10 in Prednisolone group (p=0.075); 2 in Prednisolone and none in Nepafenac had IOP elevation >15 mm Hg (p=0.188). By 4 wks none in either group had IOP elevation >15 mm Hg. Eight subjects in Prednisolone, but none in Nepafenac group needed repeat LPI (p=0.003)

Conclusions : Nepafenac is as effective as Prednisolone acetate in controlling post-LPI iritis with less impact on IOP and lesser chances of rebound iritis and iridotomy closure

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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