Efficacy And Safety Of Loteprednol In Managing Pain And Inflammation After Cataract Surgery: A Systematic Review And Meta-Analysis

To evaluate the efficacy and safety of Loteprednol in reducing post-cataract surgery pain and inflammation. 

A systematic review and meta-analysis.

We registered our protocol on PROSPERO [CRD42024593526]. We searched several electronic databases [PubMed, Cochrane Library, Web of Science, and Scopus] to identify randomized controlled trials comparing Loteprednol and placebo for post-cataract surgery pain and inflammation. The primary outcome was the proportion of patients with complete resolution of anterior chamber inflammation and grade zero pain. We assessed the quality of the studies using the RoB 2 tool and performed our meta-analysis using RevMan 5 software. 

This systematic review identified eight clinical trials (n=3,332 patients) fulfilling eligibility criteria. Our meta-analysis showed that Loteprednol significantly improved anterior chamber inflammation resolution compared to placebo at 8, 15, and 18 days postoperatively (RR= 2.25, 2.11, and 2.06 respectively, with a p-value <0.00001). Loteprednol increased the likelihood of achieving no pain (RR= 1.54, 1.66, 1.70, and 1.92 respectively with a p-value <0.00001) and reduced the need for rescue therapy (RR= 0.47, p<0.00001) while maintaining no change in intraocular pressure after 3,15 and 18 days. 

Loteprednol demonstrates significant efficacy in alleviating pain and inflammation post-cataract surgery, with notable advantages in safety, including minimal effect on intraocular pressure and fewer adverse events.