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    Ten years ago, a supposition that ocular steroids used in cataract surgery were on the decline would have been laughable. Today, with the advent of cold phacoemulsification, a smaller incision, and more effective nonsteroidal anti-inflammatory drugs (NSAIDs) on the market, the theory is not as radical as once thought. Topical steroids are still needed in today’s uncomplicated cataract surgeries “simply because you can’t predict who is and who isn’t going to have more inflammatory reaction after surgery,” said Stephen S. D., adjunct professor of ophthalmology, University of Minnesota, St. Surgeons may perform the same procedure on similar patients with no significant risk factors—one may have minimal or no inflammation post-op; the other may have quite a bit of inflammation, he said. But there are alternatives to using the stronger steroids, Dr. “There are steroids available [now]—that I call ‘safe’ steroids. At the head of the class is Lotemax [loteprednol etabonate ophthalmic suspension, Bausch & Lomb, Rochester, N. “The efficacy of this particular steroid is very high—almost as strong as prednisolone acetate or phosphate but with far fewer side effects.” “In cases of more complicated surgery or those that have uveitis or trauma, I find that steroids are imperative to reduce inflammation and improve outcomes,” said Rosa Braga-Mele, M. Ed., associate professor, University of Toronto, Canada, and director of cataract unit and surgical teaching, Mt. Despite the current phaco techniques, “significant inflammation is encountered in a large percentage of eyes following uncomplicated surgery if no medication is used,” said David F. D., clinical professor of ophthalmology, University of California, San Francisco. Chang was an investigator for Surodex, a sustained release steroid delivery system. In the Food and Drug Administration (FDA) trial, there was a placebo control arm that received no medication at all. “Although some control eyes [in that study] were indeed very quiet in the absence of any anti-inflammatory medication, most patients had significant iridocyclitis, discomfort, and photophobia until a topical steroid was instituted,” Dr. Minimizing patient discomfort while suppressing inflammation as rapidly as possible is the key to post-op cataract management, he added. High Eye Pressure after Cataract Surgery - Gary Foster, M. D. valtrex daily dosage What Are Prednisolone Eye Drops Used For? Healthy Living Prednisone and After Cataract - Reviews - Treato
     
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