Effect of nepafenac eye drops on intraocular pressure – a randomized prospective study – Accepted Manuscript

Abstract: Purpose: To report the effect of nepafenac (0.1%) eye drops on intraocular pressure in eyes with cataract.Design: Prospective, randomized clinical trial.Methods: Three hundred and twenty-seven patients with bilateral cataracts in an institutional setting were included. All patients had a baseline intraocular pressure (IOP) ≤21 mmHg without a history of intraocular surgery in past 3 months. One eye of each individual was randomized to the treatment group with the other eye acting as a control. Nepafenac (0.1%) eye drops were instilled 3 times a day in the eye that received treatment. Intraocular pressure (IOP) with Goldmann applanation tonometer (GAT) was measured at baseline, 4 and 8 weeks. Proportion of eyes with an IOP elevation of > 4 mmHg was the main outcome measure.Results: The mean age of the participants was 45.7±4.4 years which included 192 females and 135 males. The mean IOP at baseline in the treated and control eyes was 13.8±2.5 and 13.4±3.0 mmHg which reduced to 12.0±2.0 and 12.1±1.5 mmHg at the end of 8 weeks respectively. This reduction in IOP in both groups was significant (p<0.01). The difference between the IOP in the treated and control eyes at 8 weeks was not statistically significant (p=0.34). One eye in the treated group and 2 eyes in the control group had an IOP elevation of > 4 mmHg.Conclusion: Nepafenac eye drops do not increase the IOP. They can possibly be used as an alternative to steroid medications where steroid responsiveness is a concern.