Recent developments in pharmaceuticals and technology now give us more choices for treating intraocular inflammation. Newer developments in eye drops now give us different “strengths” of steroid eye drops. New drug delivery systems will be giving us sustained release of steroids.

Steroid eye drops have been the mainstay of anti-inflammatory treatment for decades indicated for most types of ocular surgery and inflammatory conditions of the eye.

From Gerson Lehrman Group:

The gold-standard of anti-inflammatory eyedrops has been prednisolone acetate 1%. Prednisolone acetate 1% has been effective in controlling intraocular inflammation as well as inflammation of the palpebral and bulbar conjunctiva.

Durezol (difluprednate) was recently released as a topical synthetic steroid indicated for post-surgical inflammation. The drug reportedly has no rise in intraocular pressure, yet has the same anti-inflammatory “power” as prednisolone acetate 1%.

Vexol (timexolone) is known as a “soft” steroid. It has less anti-inflammatory properties and is indicated for treatment of inflammatory conditions of the anterior segment and surgery.

Lotemax (loteprednol etabonate) is also a “soft” steroid, has decreased anti-inflammatory properties, does have IOP spikes and is indicated for inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment.

LASIK surgery is commonly treated with prednisolone acetate 1% 4x/day for about one week. There is generally limited corneal and anterior segment inflammation.

Intravitreal injections of triamcinolone acetonide (Kenalog) have been popular over the past several years. In this modality, the steroid is injected directly into the vitreous. Recently, FDA approved another new treatment – the Ozurdex. This drug is injected into the vitreous cavity and releases dexamethasone for a limited time. It is indicated for the treatment of macular edema caused by vein occlusions. The off-label use for intraocular inflammation is sure to follow for treatment of refractory uveitis and possible post-operative inflammation of the anterior segment and posterior segment (retina).

Tags: intraocular inflammation, prednisolone, steroid, steroid eye drops

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