Management of ocular inflammation and pain following cataract surgery: focus on bromfenac ophthalmic solution

Abstract

Recently, several new ophthalmic NSAID products have been introduced for commercial use in the United States. The purpose of this review is to briefly overview the ophthalmic NSAIDs currently in use and to discuss the management of postoperative ocular inflammation and pain following cataract surgery with a particular focus on bromfenac ophthalmic solution 0.09%. Bromfenac ophthalmic solution 0.09% is indicated for the reduction of ocular pain and inflammation following cataract surgery. Studies have shown that bromfenac ophthalmic solution 0.09% has equivalent efficacy to the other topical NSAIDs in reducing postsurgical inflammation and controlling pain. The unique chemical structure of bromfenac makes it both a potent inhibitor of the COX-2 enzyme and a highly lipophilic molecule that rapidly penetrates to produce early and sustained drug levels in all ocular tissues. Clinically, these pharmacokinetic features are manifested in a rapid reduction of postsurgical inflammation and pain with bid dosing. Bromfenac ophthalmic solution 0.09% is a versatile agent and is effective when used as either monotherapy or as an adjunct therapy to steroids.

Comparing the Efficacy Ofbromfenac 0.09% and Nepafenac 0.1% Post Cataract Surgery: A Prospective Evaluation

“…Bromfenac [1][2][3][4], a newer NSAIDs, and nepafenac [4][5][6] are two ophthalmic agents indicated in the treatment of post-operative inflammation and ocular pain from cataract surgery. Although both drugs have been reported to be efficacious in managing post-operative inflammation from cataract surgery and the mechanism of actions are similar, bromfenac and nepafenac differ in dosing: bromfenac dosing is twice-a-day while nepafenac dosing is three-times-a-day.…”

“…Although both drugs have been reported to be efficacious in managing post-operative inflammation from cataract surgery and the mechanism of actions are similar, bromfenac and nepafenac differ in dosing: bromfenac dosing is twice-a-day while nepafenac dosing is three-times-a-day. Bromfenac displayed better ocular penetration due to its lipophilic property [2] and duration permitting twice-daily dosing [1]. One significant biochemical difference is that nepafenac is a prodrug [6].…”

“…Nepafenac penetrates the cornea and is hydrolyzed to the active metabolite: amfenac [6]. The active metabolite is believed to inhibit the action of prostaglandin H synthase [6] while bromfenac inhibit prostaglandin synthesis by inhibiting cyclooxygenase 1 and 2 [2]. Bromfenac chemical structure is identical to amfenac with the exception of the bromide atom at the C4 position [2].…”

“…The active metabolite is believed to inhibit the action of prostaglandin H synthase [6] while bromfenac inhibit prostaglandin synthesis by inhibiting cyclooxygenase 1 and 2 [2]. Bromfenac chemical structure is identical to amfenac with the exception of the bromide atom at the C4 position [2]. The addition of bromine enhances lipophilicity [2], facilitates penetration [2], and increases duration of action (half-life) [2].…”

“…Bromfenac chemical structure is identical to amfenac with the exception of the bromide atom at the C4 position [2]. The addition of bromine enhances lipophilicity [2], facilitates penetration [2], and increases duration of action (half-life) [2].…”