efficacy of preoperative topical diclofenac for prevention of post-cataract surgery inflammation

purpose: to evaluate the efficacy of pretreatment with diclofenac sodium 1% eye drop for prevention of post-cataract surgery ocular inflammation. methods: a double blind clinical trial was performed on 111 patients who were scheduled for phacoemulsification and intraocular lens implantation (pe+iol) at feiz hospital, isfahan-iran. cases with traumatic cataract and complicated surgery were excluded. patients were randomly assigned to three groups: (1) controls; (2) treatment with one drop of diclofenac sodium 1% qid one day before surgery; and (3) treatment with one drop of diclofenac sodium 1% qid for three days preoperatively. all eyes received topical steroid and antibiotic, postoperatively. postoperative anterior chamber (ac) reaction, ocular pain, burning, red eye, atonic mydriasis and intraocular pressure were evaluated on days 1, 3, 14 and 30. results: the study included 70 male and 41 female subjects with mean age of 61.03+8.35 years. ocular pain was significantly more prevalent and severe in controls compared to other groups on postoperative days 1, 3 and 14. ac reaction was also more prevalent and severe in controls than the other two groups only on the first postoperative day. the prevalence and severity of red eye on days 1, 14 and 30 postoperatively were higher in controls compared to the two other groups without any difference by the third postoperative day. eye burning was more prevalent in the control group than the other two groups only on days 1 and 3. the active treatment groups had no difference in terms of the above-mentioned characteristics at any stage; except for ac reaction on the first postoperative day which was more severe in the one-day treatment group compared to the three-day group. there was no significant difference between the three groups regarding relative miosis intraoperatively. postoperative changes in intraocular pressure were within normal limits in all groups. conclusion: pretreatment with diclofenac sodium 1% can reduces the incidence and severity of post-cataract surgery ac reaction, eye burning, red eye and ocular pain, particularly during the first postoperative week.