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Comparison of loteprednol etabonate 0.5% and dexamethasone phosphate 1.0% in controlling anterior chamber inflammation after uneventful phacoemulsification in type 2 diabetics

Poster Details

First Author: M.Ali PAKISTAN

Co Author(s):    N. Butt   M. Ayub                 

Abstract Details

Purpose:

To evaluate the efficacy of loteprednol etabonate (LE) 0.5% versus dexamethasone phosphate (DP) 1.0% for the control of postoperative inflammation in type 2 diabetic patients having uneventful phacoemulsification.

Setting:

Department of Ophthalmology, Allama Iqbal Medical College/ Jinnah Hospital, Lahore, Pakistan

Methods:

Type 2 diabetic patients who underwent uncomplicated phacoemulsification were randomized to receive LE 0.5% or DP 1% 4 times daily in addition to moxifloxacin for a period of 21 days after surgery. Visual acuity, intraocular pressure, and anterior chamber cells and flare intensity were assessed over 3 weeks after phacoemulsification. The primary endpoint was the percentage of patients with complete resolution of anterior chamber cells and flare intensity in patients treated with loteprednol and dexamethasone at the end of week 1, 2 and 3 post-operatively.

Results:

The study enrolled 152 type 2 diabetic patients (77 in LE 0.5% and 75 in DP 1% group). Equivalency was achieved in resolution of anterior chamber inflammation between the 2 treatment groups with no significant differences throughout the 3-weeks follow-up. 28.1% versus 32.3%, 61.9% versus 65.3% and 79.6% versus 85.6% of the patients in Loteprednol and Dexamethasone group had complete resolution of anterior chamber inflammation on day 8, 14 and 21 respectively. There was less fluctuation in intraocular pressure in patients treated with LE than patients treated with DP, particularly on day 5 and 9 postoperatively (p = 0.015).

Conclusions:

Loteprednol etabonate 0.5% proved itself non-inferior to dexamethasone phosphate 1.0% in controlling post-operative anterior chamber inflammation after cataract surgery in type 2 diabetic patients. In addition, treatment with loteprednol etabonate 0.5% resulted in less IOP fluctuation making it a very good post-operative anti-inflammatory drug especially in steroid responders.

Financial Disclosure:

NONE

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