Comparison of Efficacy and Safety of Loteprednol Etabonate 0.5% and Topical Dexamethasone 1% in Post-Vitrectomy Inflammation

Ocul Immunol Inflamm. 2019;27(2):312-318. doi: 10.1080/09273948.2017.1410182. Epub 2017 Dec 28.

Abstract

Purpose: To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV).

Methods: A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups.

Results: The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005).

Conclusions: Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.

Keywords: Dexamethasone; inflammation; loteprednol etabonat; pars plana vitrectomy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Allergic Agents / administration & dosage
  • Child
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Loteprednol Etabonate / administration & dosage*
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Treatment Outcome
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Uveitis / etiology
  • Vitrectomy / adverse effects*
  • Young Adult

Substances

  • Anti-Allergic Agents
  • Ophthalmic Solutions
  • Loteprednol Etabonate