Topical bromfenac as good as nepafenac in controlling Post Laser Peripheral Iridotomy inflammation

The primary outcome (endpoint) was uncontrolled inflammation, defined as symptomatic inflammation within 1 week post-LPI, the presence of anterior chamber cell at 2 weeks, or rebound inflammation after medication discontinuation. The secondary outcome was patient-reported comfort levels to study medications based on GSS and Likert scale.

The results are:

At 2 weeks post-LPI, 7 patients (6 PACS, 1 PAC) in the nepafenac group and 2 PACS patients in bromfenac group achieved the primary endpoint, without a difference between the medication groups (p=0.09). Post-LPI burning, smarting, and stinging was more common in the bromfenac group as compared to the nepafenac group (p=0.01), which also had a higher comfort score on a Likert scale (p=0.004). Need for repeat LPI was comparable (10.0% in the nepafenac group vs. 15.4% in the bromfenac group; p=0.22). Multivariate analysis revealed that a greater number of laser shots was associated with the need for repeat LPI (OR 1.05, 95% CI 1.00-1.10, p=0.04).

Thus, topical 0.09% bromfenac is non-inferior to 0.1% nepafenac in controlling inflammation following LPI in PACS and PAC eyes. Nepafenac may be associated with higher patient-reported comfort.

Reference:

0.1% Nepafenac Vs. 0.09% Bromfenac Eye Drops for Post Laser Peripheral Iridotomy Inflammation – A Randomised Controlled Trial by Lavanya G.Shankar et al. published in the Ophthalmology Glaucoma.

https://www.sciencedirect.com/science/article/abs/pii/S2589419622000278?via%3Dihub