Nepafenac: An Ophthalmic Nonsteroidal Antiinflammatory Drug for Pain After Cataract Surgery

Abstract

The 2 nepafenac products appear to be equally efficacious, with a slightly increased adverse event rate in patients using the 0.3% versus 0.1% formulation. Head-to-head clinical trials that compare the 0.3% product with the 0.1% product or other commercially available NSAIDs are unavailable.

Effect of Nepafenac Eye Drops on Pain Associated With Pterygium Surgery

“…Similarly, the authors who used nepafenac in photorefractive keratectomy (PRK) and cataract surgery concluded that topical nepafenac was safe and effective to perform topical analgesia. [9][10][11][12] The control of pain originating from the cornea and/or conjunctiva is a problem for the patients undergoing surgeries related to ocular surface, such as pterygium surgery, refractive surgery, and strabismus surgery. There are many techniques and methods described for the management of postoperative pain.…”

“…7,8 Nepafenac (Nevanac; Alcon, Turkey) has been used to control the pain after many ocular surgeries. [9][10][11][12] It is unique among ophthalmic NSAIDs in that it is a prodrug deaminated to amfenac, a highly effective nonselective COX inhibitor. 13 It has superior corneal permeability characteristics compared with other available topical NSAIDs that minimize surface complications often observed with topical NSAIDs 14 and has been proven to have an acceptably great margin of safety.…”

Comparison of the efficacy and patients’ tolerability of Nepafenac and Ketorolac in the treatment of ocular inflammation following cataract surgery: A meta-analysis of randomized controlled trials

“…With the significant progress in surgical techniques and apparatus such as phacoemulsification, modern cataract surgery has achieved a reduction of physical surgical trauma and a decrease in the release of prostaglandins, which plays the main role in the progress of postoperative ocular inflammation [1, 2]. However, most patients still manifest clinically significant postoperative ocular inflammation after cataract surgery.…”

“…However, most patients still manifest clinically significant postoperative ocular inflammation after cataract surgery. Uncontrolled intraocular inflammation may disrupt the blood-ocular barrier and cause the entry of inflammatory cells and cytokines into aqueous humor, leading to patient discomfort, delayed recovery, suboptimal visual outcomes and even further complications such as cystoid macular edema (CME), synechiae formation, raised intraocular pressure (IOP), corneal edema, intraoperative miosis, hyperemia, photophobia and so on [2–4]. In this epoch of patients’ high expectations and premium intraocular lenses, not only suboptimal visual outcomes but also postoperative discomfort are unacceptable to most patients.…”

“…[5, 6] Currently, more cataract surgeons are becoming interested in avoiding steroid use alone, seeking alternative or complementary drugs which are equally effective but have fewer side-effects [5]. Topical non-steroidal anti-inflammatory drugs (NSAIDs) are commonly applied in the management of noninfectious ocular inflammation following ophthalmic surgery, the combination therapy of NSAIDs and steroid have also shown a synergistic effect on ocular inflammation following cataract surgery [2–3,5–7]. The obvious advantages of NSAIDs over corticosteroids include relative stable IOP, lower risk of secondary infections and extra benefit of analgesia [8–9].…”