Difluprednate improves results

Article

Pre- and postoperative treatment with the potent corticosteroid difluprednate ophthalmic emulsion 0.05% signficantly improves outcomes after cataract surgery compared with use of prednisolone acetate ophthalmic suspension 1% and so results in improved patient satisfaction, according to one expert.

The second eye was operated on after a 2-week interval, and all surgeries were uncomplicated. The corticosteroids were administered in a pulsed regimen perioperatively (10 doses) and then with a 2-week tapering course postoperatively.

"Despite advances in cataract surgery technique and technology, we have been disappointed that many patients still have cloudy corneas or even mild corneal thickening postoperatively that decreases their quality of vision," said Dr. Donnenfeld, founding partner, Ophthalmic Consultants of Long Island and Connecticut, and clinical professor of ophthalmology, New York University, New York. "Results of our controlled study document that use of difluprednate addresses this issue and improves the postoperative results in statistically and clinically significant ways.

"I have been using difluprednate in all of my cataract surgery patients for [more than] a year," he added. "My patients are much happier because of the 'wow' effect on their vision and are more likely to spread the word to everyone they know about their positive experience."

Several lines of evidence led Dr. Donnenfeld and colleagues to consider the pulsed difluprednate regimen as a solution to achieving improved outcomes after cataract surgery. Recognizing that high-dose corticosteroids are used in neurology and neurosurgery to reduce post-traumatic neuronal degeneration, improve neuronal function, and prevent neuronal cell death after spinal cord injury, they reasoned that because the corneal endothelium is also of neuroectodermal origin, a similar regimen might be beneficial for corneal protection in cataract surgery.

"I have found difluprednate to be the steroid of choice for all complicated cataract [procedures]," said Dr. Holland, director of cornea services, Cincinnati Eye Institute, and professor of ophthalmology, University of Cincinnati. "These include cases involving iris manipulation with hooks or rings, prolonged phaco time due to a dense cataract, capsule fixation or IOL suturing, and capsule tear or vitreous loss."

Newsletter

Want more insights like this? Subscribe to Optometry Times and get clinical pearls and practice tips delivered straight to your inbox.

Recent Videos
Patricia Buehler, MD, MPH, at ASCRS 2025
Brett Bielory, MD, at ASCRS 2025
At ASCRS 2025, Alex Hacopian, MD, shares information from his presentation on next-gen presbyopia-correcting intraocular lenses.
Rhue and Canto-Sims talk the value of contact lens patients, financial insights, and key benefits of implementing a contact lens management system.
Eva Kim, MD, shares visual outcomes of EVO implantable collamer lens in patients with low to moderate myopia
Drs Brianna Rhue and Diana Canto-Sims discuss the benefits of implementing a contact lens management system that can help improve lens sales at your practice.
Dr Ashley Wallace Tucker speaks on the Myopia Management Navigator.
Matt Jones, OD; Matt Burns, OD; and Joe Sugg, OD; detailed what optometrists can expect to change when HB 1353's regulations are enacted later this year.
Arkansas Optometric Association legislative cochairs Matt Jones, OD; Matt Burns, OD; and Joe Sugg, OD, discuss their involvement in their bill and provide context for its relevance.
Elise Kramer, OD, FAAO, FSLS, describes her take on a multidisciplinary approach to dry eye
© 2025 MJH Life Sciences

All rights reserved.