HealthDay News — For patients undergoing uncomplicated cataract surgery, a combination of prednisolone and nonsteroidal anti-inflammatory drug (NSAID) eye drops is not superior to NSAID monotherapy, and initiating prophylactic treatment 3 days before surgery is no better than on the day of surgery, according to a study published online August 12 in JAMA Ophthalmology.

Jesper Høiberg Erichsen, MD, PhD, from Rigshospitalet Glostrup in Denmark, and colleagues conducted a randomized clinical trial involving low-risk patients undergoing phacoemulsification for age-related cataract by an experienced surgeon. A total of 470 participants were randomly assigned to one of 5 anti-inflammatory prophylactic regimens: eye drops with a combination of prednisolone and ketorolac tromethamine, with or without preoperative initiation (preoperative prednisolone plus NSAID [control] and postoperative prednisolone plus NSAID groups); ketorolac monotherapy with or without preoperative initiation (preoperative and postoperative NSAID groups); or sub-Tenon depot of dexamethasone phosphate (sub-Tenon group).

The researchers found that mean central subfield thickness (CST) was 250.7μm in the control group, 250.7μm in the postoperative prednisolone plus NSAID group, 251.3μm in the preoperative NSAID group, 249.2μm in the postoperative NSAID group, and 255.2μm in the sub-Tenon group at three months after surgery. Compared with control, there were no significant differences observed in CST or visual acuity and no differences seen between the preoperative and postoperative groups. In the sub-Tenon group, 56.6% needed additional anti-inflammatory treatment.

“NSAID monotherapy with initiation on the day of surgery may be preferred as an anti-inflammatory prophylactic regimen in uncomplicated cataract surgery,” the authors write.

Abstract/Full Text