Difluprednate achieves a similar clinical outcome after trabeculectomy compared to prednisolone acetate at a significantly lower drop frequency.
Background: The success of trabeculectomy is highly dependent on postoperative control of inflammation and fibrosis. Prednisolone acetate is the most commonly used topical steroid after ophthalmic surgery. However, non-compliance and adherence problems are constantly thwarting this goal. A topical e...
| Publicado en: | Therapeutic Advances in Ophthalmology pp. 1 - 16 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
5/11/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=185098420&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 185098420 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25158414 LAW0 jtl: Therapeutic Advances in Ophthalmology issn: 25158414 maglogo: Y pubinfo: dt: 5/11/2025 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 185098420 185098420 185098420 10.1177/25158414251338602 185098420 ppf: 1 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Difluprednate achieves a similar clinical outcome after trabeculectomy compared to prednisolone acetate at a significantly lower drop frequency. aug: au: Töteberg-Harms, Marc Rhee, Douglas J. affil: Conceptualization, Department of Ophthalmology & Visual Sciences, University of Iowa, Iowa City, IA, USA sug: subj: Trabeculectomy Ophthalmic Solutions Administration and Dosage Prednisolone Administration and Dosage Glucocorticoids Administration and Dosage Administration, Topical Inflammation Prevention and Control Fibrosis Prevention and Control Postoperative Complications Prevention and Control Treatment Outcomes Evaluation Human Comparative Studies Retrospective Design Record Review Intraocular Pressure Antiglaucoma Agents Administration and Dosage Treatment Failure Treatment Duration Medication Compliance Male Female Middle Age Aged Funding Source Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: The success of trabeculectomy is highly dependent on postoperative control of inflammation and fibrosis. Prednisolone acetate is the most commonly used topical steroid after ophthalmic surgery. However, non-compliance and adherence problems are constantly thwarting this goal. A topical eye drop regimen that requires fewer drops per day and still achieves the same success rates regarding controlling fibrosis and inflammation is desirable. Objective: This study aimed to evaluate whether similar success rates can be achieved with topical difluprednate, comparable to prednisolone acetate, following trabeculectomy. Design: A single-center, single-surgeon retrospective chart review. Methods: Retrospectively, medical records were evaluated. Inclusion criteria were age ⩾18 years with no upper limit and a diagnosis of open-angle glaucoma. Exclusion criteria were follow-up of <3 months and a history of a concurrent surgery that lowers IOP other than laser trabeculoplasty, cataract surgery, or trabecular meshwork bypass procedures. Success was defined as IOP ⩽ 21 mmHg and ⩾20% reduction below baseline after 1 month, no hypotony (IOP > 5 mmHg), no subsequent glaucoma surgery, and no loss of light perception vision. Primary outcome measures were time to failure and Kaplan–Meier survival, and secondary outcome measures were change in IOP, number of anti-glaucoma medications (AGM), and postoperative interventions and complications. Results: In all, 115 eyes were analyzed: 75 eyes in the prednisolone acetate group, and 40 eyes in the difluprednate group. Baseline characteristics and demographics were similar between the groups. IOP and AGM were significantly lowered, with no difference between the two groups. Failure rates varied between 12% and 31% at 1 year in the prednisolone arm, and between 12% and 35% in the difluprednate arm. No differences between the two treatment arms were found regarding survival statistics. Conclusion: There was no difference in the success rate between the drug used to treat postoperative inflammation and prevent scarring after trabeculectomy. However, fewer drops per day were necessary in the difluprednate group. Both groups showed no difference in the amount by which IOP and AGM were reduced. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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