Dexamethasone inserts are a safe and effective option to manage postoperative inflammation in patients after cataract surgery, according to findings published in Clinical Ophthalmology. Further, patients did not report pain 1 week or 1 month post-surgery.

Controlling inflammation after surgery is essential to ensuring a positive patient outcome after cataract surgery. However, using eye drops or adhering to complication medication schedules can be cumbersome for patients.

The US Food and Drug Administration recently approved Dextenza (dexamethasone, Ocular Therapeutix), a sustained-release dexamethasone intracanalicular insert, for the treatment of postoperative ocular inflammation and pain. The insert, which is placed in the canaliculus, contains 0.4 mg of active dexamethasone, providing a sustained, tapered release of the medication for 30 days.


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To evaluate the safety and efficacy of the insert, researchers in this retrospective study looked at patients who underwent cataract surgery and received a dexamethasone intracanalicular insert before surgery in one eye (same-day group) and on postoperative day 1 in the other eye (postoperative group). The study included 62 eyes of 31 patients.

One week after surgery, 52% of the eyes (n=16) in the same-day group saw the complete resolution of inflammation, as did 58% (n=18) in the postoperative group, according to investigators. However, 1 eye in the same-day group required additional therapy for rebound inflammation. No eyes in the post-op group required follow-up treatment. In addition, no patients reported pain in either eye 1 week and 1 month after surgery. No implant-related adverse events were reported, according to researchers.

“The results of this study indicate that the dexamethasone depot can be safely inserted preoperatively on the day of surgery or on postoperative day 1 for postoperative control of inflammation,” study authors report. “Both groups demonstrated favorable results with regard to resolution of inflammation, and there was no significant difference in clinical outcomes between the 2 eyes.”

The limitations of this study include its sample size, single-site design, and subjective, non-standardized method of assessing pain. In addition, researchers did not control for patients’ use of topical medications for comparison. 

Disclosure: Some of the study’s authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  

Reference

Saenz B, Ferguson TJ, Abraham N, et al. Evaluation of same-day versus next-day implantation of intracanalicular dexamethasone for the control of postoperative inflammation and pain following cataract surgery. Clin Ophthalmol. Published online December 7, 2021. doi:10.2147/OPTH.S334297