Comparison of Loteprednol Etabonate 0.5% Tobramycin 0.3% Combination Eye Drop with Prednisolone acetate 1% for Treatment of Inflammation following Phacoemulsification

Abstract

Background: Inflammation is inevitable following cataract surgery. This study compared the efficacy and safety of topical loteprednol etabonate with prednisolone acetate in controlling ocular inflammation following cataract surgery. Methods: All patients who underwent cataract surgery in Ramathibodi Hospital, receiving either loteprednol etabonate 0.5% plus tobramycin 0.3% ophthalmic suspension or prednisolone acetate 1%, four times daily, were included. Medical records of 299 eligible patients in one year were retrospectively reviewed. Demographic data, clinical findings, and subjective symptoms at days 8 and 28 postoperatively were recorded. The primary outcome was anterior chamber cell reaction grades. Results: Anterior chamber cell at day 8 of 143, 12, and 14 patients in loteprednol etabonate group were graded as 0, 0.5+, and 1+ or more, while there were 56, 59, and 15 patients in prednisolone acetate group, respectively (p < 0.001). However, the proportion of patients in each group was not significantly different at day 28 (p = 0.057) by Pearson’s chi-squared test. In these groups, changes in mean intraocular pressure were -1.66 mmHg and -1.56 mmHg, respectively, at day 8 (p = 0.770), while they were -2.18 mmHg and -1.25 mmHg, respectively, at day 28 (p = 0.006). Conclusion: Loteprednol etabonate plus tobramycin ophthalmic suspension was not less effective than prednisolone acetate in controlling anterior chamber cell reaction during the postoperative period. Reductions in mean intraocular pressure were observed in both groups.