Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

Area of Science:

• Ophthalmology
• Surgical Innovation
• Pharmacology

Background:

• Postoperative pain and inflammation are common after pterygium surgery.
• Prolonged steroid therapy is often required, increasing patient medication burden.

Purpose of the Study:

• To compare the efficacy of intracanalicular dexamethasone 0.4 mg versus topical prednisolone acetate (PA) 1% in managing postoperative pain and inflammation.
• To evaluate the safety and effectiveness of intracanalicular dexamethasone as an alternative to standard topical steroids.

Main Methods:

• An open-label, prospective, interventional, nonrandomized comparative trial involving 30 patients.
• Group A received an intracanalicular dexamethasone insert plus topical PA 1%.
• Group B received only topical PA 1% with a more intensive initial dosing schedule.

Main Results:

• No statistically significant differences in patient-reported pain or satisfaction were observed between groups at multiple postoperative time points.
• No significant differences in ocular hyperemia, corneal reepithelialization, or recurrence rates were found.
• Transient ocular hypertension occurred in nine eyes (seven in the dexamethasone group, two in the control group).

Conclusions:

• Intracanalicular dexamethasone 0.4 mg may decrease the medication burden for patients requiring extended postoperative steroid treatment.
• It presents a safe and effective alternative to topical prednisolone acetate 1% for controlling pain and inflammation following pterygium surgery.