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Diclofenac versus fluorometholone after strabismus surgery in children
Hee Kyung Yang1, Sang Beom Han2, Jeong-Min Hwang1
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Insights
Topical diclofenac effectively manages intraocular pressure after strabismus surgery, unlike fluorometholone, especially in children under seven. Diclofenac offers a safer alternative to steroid eye drops for pediatric patients.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Strabismus surgery requires effective postoperative management to control inflammation and intraocular pressure (IOP).
- Steroidal anti-inflammatory drugs are commonly used but can increase IOP.
Purpose of the Study:
- To compare the efficacy of topical diclofenac sodium versus fluorometholone in managing IOP and conjunctival inflammation post-strabismus surgery.
Main Methods:
- Retrospective analysis of 60 Korean children undergoing strabismus surgery for intermittent exotropia.
- Patients received either topical diclofenac 0.1% or fluorometholone 0.1% for up to 4 weeks.
- Evaluated IOP, discomfort, conjunctival inflammation, and injection at 1, 2, 3, and 4 weeks.
Main Results:
- Fluorometholone group showed a significant IOP increase (p<0.001) compared to baseline; 23% experienced ≥10 mm Hg rise.
- Diclofenac group demonstrated no significant IOP increase.
- Higher risk of IOP elevation (≥10 mm Hg) with fluorometholone in children under 7.
- No significant differences in discomfort, inflammation, or injection between groups.
Conclusions:
- Topical diclofenac is a suitable steroid substitute for managing IOP after strabismus surgery.
- Diclofenac is particularly recommended for young children under 7 years old due to the risks associated with fluorometholone.
Aims:
To compare the effects of topical diclofenac sodium with those of fluorometholone on intraocular pressure (IOP) and conjunctival inflammation after strabismus surgery.
Methods:
We retrospectively analysed 60 Korean children who underwent strabismus surgery for intermittent exotropia in an institutional referral centre. Patients received topical diclofenac 0.1% or fluorometholone 0.1% after surgery for up to 4 weeks. IOP, patient discomfort, conjunctival inflammation and conjunctival injection were evaluated at 1, 2, 3 and 4 weeks after surgery.
Results:
In the fluorometholone group, 23% showed an increase of ≥10 mm Hg compared to the baseline IOP within 4 weeks of surgery. The fluorometholone group showed a significant change in IOP compared to baseline (p<0.001) at all follow-up time points, whereas the diclofenac group showed no significant increase in IOP. An increased risk of IOP elevation of ≥10 mm Hg was observed after fluorometholone use in patients under 7 years of age. There was no significant difference in patient discomfort, conjunctival inflammation or conjunctival injection between the two groups. Conjunctival injection was more pronounced with muscle resection than with recession at 1 month after surgery.
Conclusions:
Postoperative topical diclofenac is an excellent substitute for steroids, particularly in young children under 7 years of age.
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