Intraocular pressure elevation from topical difluprednate use

Meehan, Kelly; Vollmer, Lori; Sowka, Joseph

doi:10.1016/j.optm.2010.09.001

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…The data from this study confirmed earlier reports showing an increase in IOP when DFBA is compared to PA 25,28,30. Importantly, in this study, the mean IOP remained ≤21 mmHg for both PA and DFBA patients.…”

Section: Discussionsupporting

confidence: 91%

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Kusne

Kang

Fintelmann

2016

OPTH

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PurposeTo compare the effect of topical prednisolone acetate 1% (PA) used after routine cataract surgery to the effect of difluprednate 0.05% (DFBA) used for the same indication on intraocular pressure (IOP).MethodsAn electronic query was created to gather information from all cataract surgeries between January 2010 and January 2015 within the electronic health record database at Barnet Dulaney Perkins, a multicenter, multiphysician private practice in Phoenix, Arizona. Information collected included age, sex, diabetes status, glaucoma history, medication regimen (use of PA or DFBA), and IOP before surgery, 5–10 days postoperatively (TP1) and 3–6 weeks postoperatively (TP2). Postoperative IOP measurements were compared to baseline IOP measurement in each patient.ResultsRegardless of steroid used, all patients in this study experienced an increase in IOP within TP1 and returned to baseline IOP (±2.0 mmHg) by TP2. Patients who received DFBA showed a statistically significant increase in IOP at TP1 compared to those on PA (P<0.001) with the mean IOP an average 0.60 mmHg higher (95% CI =0.3, 0.9). The odds ratio of a clinically significantly increased IOP at TP1 (defined as overall IOP ≥21 mmHg and an increase of ≥10 mmHg) in DFBA-treated patients was 1.84 (95% CI =1.4, 2.6). In patients treated with PA, 3% reached a significantly increased IOP, compared to 4.4% of patients in the DFBA group (P<0.05). Risk factors for increased IOP were identified, and include advanced age (>75) (P<0.005) and a history of glaucoma (P<0.001).ConclusionIn postoperative cataract patients, use of DFBA increased the risk of a clinically significant IOP increase.

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Section: Discussionsupporting

confidence: 91%

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Kusne

Kang

Fintelmann

2016

OPTH

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“…When clinically indicated, prescription of an IOP-lowering topical medication may be appropriate. 30,31 Long-term use of ophthalmic corticosteroids should be also avoided or minimized when possible because it may result in glaucoma, with damage to the optic nerve, visual field defects, VA loss, or cataract formation. 11, 24,32,33 The present study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Difluprednate 0.05% Versus Prednisolone Acetate 1% for Endogenous Anterior Uveitis: A Phase III, Multicenter, Randomized Study

Sheppard

Toyos

Kempen

et al. 2014

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Endogenous anterior uveitis (AU), when untreated, may lead to vision loss. This study compared the safety and efficacy of difluprednate versus prednisolone acetate for the treatment of this condition.METHODS. This phase III, double-masked, noninferiority study randomized patients with mild to moderate endogenous AU to receive difluprednate 0.05% (n ¼ 56) four times daily, alternating with vehicle four times daily, or prednisolone acetate 1% (n ¼ 54) eight times daily. The 14-day treatment period was followed by a 14-day dose-tapering period and a 14-day observation period. The primary efficacy end point was change in anterior chamber cell grade (range, 0 for 1 cell to 4 for >50 cells) from baseline to day 14.RESULTS. At day 14, the mean change in anterior chamber cell grade with difluprednate was noninferior to that with prednisolone acetate (À2.2 vs. À2.0, P ¼ 0.16). The proportions of difluprednate-treated patients versus prednisolone acetate-treated patients demonstrating complete clearing of anterior chamber cells at day 3 were 13.0% vs. 2.1% (P ¼ 0.046) and at day 21 were 73.9% vs. 63.8% (P ¼ 0.013). A significant between-group difference in the mean IOP increase was seen at day 3 (2.5 mm Hg for difluprednate-treated patients and 0.1 mm Hg for prednisolone acetate-treated patients, P ¼ 0.0013) but not at other time points. The mean IOP values in both groups remained less than 21 mm Hg throughout the study.CONCLUSIONS. Difluprednate 0.05% four times daily is well tolerated and is noninferior to prednisolone acetate 1% eight times daily for the treatment of endogenous AU. (ClinicalTrials.gov number, NCT01201798.)

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“…Meehan K et al [12] (2010) studied intraocular pressure elevation from topical difluprednate use. Difluprednate 0.05% has a reported associated increase in intraocular pressure (IOP) in 3% of patients.…”

Section: Cmentioning

confidence: 99%

Comparison of Efficacy and Safety of Dexamethasone 0.1% and Difluprednate 0.05% in the Management of Ocular Inflammat Ion After Phacoemulsification

Chaudhary¹,

Arora²,

Gupta³

et al. 2015

jemds

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PURPOSE:To compare the efficacy and safety of dexamethasone 0.1% and difluprednate 0.05% ophthalmic solution in the management of ocular inflammation after phacoemulsification. DESIGN: Prospective randomized control study. SETTING: Ophthalmology Department, Mahatma Gandhi Medical College & Hospital, Sitapura, Jaipur. METHODS: 50 patients (Age 45 to 75 year) with senile cataract were taken. After surgery 25 patients were treated with dexamethasone 0.1% and 25 patients with difluprednate 0.05%. Patients were examined and compared on postoperative day 1, 7, 14, 28 for anterior segment, intraocular pressure and side effects. RESULTS: Anterior chamber cell loss on day 7 was more in difluprednate group. Both drugs show equivalent efficacy in decreasing the anterior chamber flare. No clinically significant IOP elevation was noted in any patient during study. The adverse effects reported were mild discomfort and watering and foreign body sensation were slightly more in dexamethasone group than difluprednate group. No serious adverse effects were reported during the study. CONCLUSION: Both drugs dexamethasone 0.1% and difluprednate 0.05% shows equivalent efficacy to control postoperative inflammation with difluprednate being more rapid. FINANCIAL DISCLOSURE: No author has a financial interest in any material or method mentioned.

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Intraocular pressure elevation from topical difluprednate use

Cited by 11 publications

References 5 publications

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

A retrospective analysis of intraocular pressure changes after cataract surgery with the use of prednisolone acetate 1% versus difluprednate 0.05%

Difluprednate 0.05% Versus Prednisolone Acetate 1% for Endogenous Anterior Uveitis: A Phase III, Multicenter, Randomized Study

Comparison of Efficacy and Safety of Dexamethasone 0.1% and Difluprednate 0.05% in the Management of Ocular Inflammat Ion After Phacoemulsification

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