A randomized controlled study to evaluate and compare the effect of prednisolone, dexamethasone, and difluprednate eye drops on intraocular pressure in post-cataract surgery patients

Background: Topical corticosteroids are the effective anti-inflammatory agents prescribed following the cataract surgery. Their prolonged use can produce many side effects and one of them is steroid-induced glaucoma. Commonly used steroids in ocular therapy have tendency to cause rise in intraocular pressure (IOP). Elevated IOP if left untreated can ultimately progress to steroid-induced glaucoma. Any change in IOP should be monitored so that it can be detected and treated on time. Hence, the present study is planned. Aims and Objectives: The aims and objectives of the study are to evaluate and compare the effect of prednisolone, dexamethasone, and difluprednate eye drops on IOP in post-cataract surgery patients. Materials and Methods: A total of 90 patients were randomly allocated into three groups of thirty each receiving prednisolone, dexamethasone, and difluprednate eye drops, respectively, for 6 weeks in a tapering dose. Pre-operative and post-operative IOP measurements were noted and the patients were followed up for 1½ months. Results: Among 90 patients about 4.44% (n = 4) of them showed IOP elevation of ≥10 mmHg from baseline. About 14.44% (n = 13) patients showed moderate rise in IOP that is ≥5 mmHg. Clinically significant IOP elevation that is IOP increase of ≥10 mmHg and overall IOP of ≥21 mmHg was seen in 3.33% (n = 3) of the patients, and all of them belonged to difluprednate group. The mean post-operative IOP between the three treatment groups was not statistically significant. Conclusion: Difluprednate is having a higher potential of causing early and significant rise in IOP and hence has to be used judiciously with constant monitoring.