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Comparing Three Post-Op Regiments for Management of Inflammation Post Uncomplicated Cataract Surgery. “ Are Steroids Really Necessary? ”

Hon-Vu Q. Duong, Kenneth C. Westfield and Isaac C. Singleton

Purpose: To compare intraocular pressure (IOP) differences; degrees of anterior chamber inflammation and macular edema between three different treatments.   Setting: Single center, private, teaching practice in Las Vegas, Nevada.   Methods: Prospective, randomized, single-blind study. Patients in the Control group received gatifloxacin 0.3%, prednisolone acetate 1%, and bromfenac 0.09%; Group #I received gatifloxacin and bromfenac; and Group #II was given one intraoperative steroid (Triamcinolone) injection and gatifloxacin and bromfenac in the post-operative period.   Results: Elevated IOPs were noted on post-operative day one but were statistically insignificant (p=0.15). The elevated IOPs were statistically significant for the glaucoma patients (p=0.004). All IOPs returned to baseline after 1 week   The degree of anterior segment inflammation was not statistically significant (p=0.39) between the studied populations.   The foveal thickness (FT) was used to determine the degree of macula inflammation. The degree of macula inflammation was not statistically significant between the three groups (p=0.82).   Conclusions: This study demonstrated efficacy between the three regimens in decreasing and resolving anterior chamber inflammation and preventing the development of macular edema. The intraocular spikes although more significant on post-operative day 1, returned to baseline by the one week post-surgery visit.