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Comparison of effect of nepafenac and diclofenac ophthalmic solutions on cornea, tear film, and ocular surface after cataract surgery: the results of a randomized trial

Authors Kawahara A, Utsunomiya T, Kato Y, Takayanagi Y

Received 4 December 2015

Accepted for publication 16 February 2016

Published 4 March 2016 Volume 2016:10 Pages 385—391


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Atsushi Kawahara,1–3 Tsugiaki Utsunomiya,4 Yuji Kato,2 Yoshinori Takayanagi3

1Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan; 2Sapporo Kato Eye Clinic, Sapporo, Hokkaido, Japan; 3Takayanagi Clinic, Kushiro, Hokkaido, Japan; 4Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan

Background: The aim of this study was to compare the effects of nepafenac ophthalmic suspension 0.1% (Nevanac) and diclofenac sodium ophthalmic solution 0.1% (Diclod) on the cornea, tear film, and ocular surface after cataract surgery.
Methods: A total of 60 eyes (60 patients) were selected for this study, with no ocular diseases other than cataract (scheduled for cataract surgery by one surgeon). Patients were randomly enrolled to receive nepafenac or diclofenac in the perioperative period, and cataract surgery was performed using torsional microcoaxial phacoemulsification and aspiration with intraocular lens implantation via a transconjunctival single-plane sclerocorneal incision at the 12 o’clock position. We compared intra- and intergroup differences preoperatively and postoperatively in conjunctival and corneal fluorescein staining scores, tear film breakup times, Schirmer’s tests, the Dry Eye Related Quality of Life Scores, and tear meniscus areas using anterior segment optical coherence tomography.
Results: The diclofenac group had significantly higher conjunctival and corneal fluorescein staining scores at 4 weeks postoperatively compared with the nepafenac group (P<0.001). Within the diclofenac group, significantly higher conjunctival and corneal fluorescein staining scores were noted at 4 weeks postoperatively than those seen preoperatively (P<0.001) and at 1 week postoperatively (P<0.001). No statistically significant differences were found in any other items.
Conclusions: Nepafenac ophthalmic suspension 0.1% is considered safe for the corneal epithelium after cataract surgery.

nepafenac, diclofenac, cornea, tear film, ocular surface, cataract surgery

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