Inflammation in post operative surgery

September 7, 2010

Bausch + Lomb and Croma-Pharma presented a symposium exploring some of the opportunities and challenges associated with the management of a patient with postoperative inflammation in cataract surgery.

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“The time has come for peace between steroids and NSAIDs. I think we have to consider combination therapies, in order to be on the safe side and this is the strategy we can propose to our patients,” said Dr Bahram Bodaghi, professor of ophthalmology, University of Pierre and Marie Curie, Pitie-Salpetriere Hospital, Paris, France, speqaking at ESCRS in Paris at the Bausch + Lomb and Croma-Pharma symposium.

He went on to explore the clinical use of NSAIDs in ophthalmology, and their increasing role in the prevention and therapy of cystoid macular oedema (CME). “Combination is becoming the standard of care,” he said.

The symposium explored some of the opportunities and challenges associated with the management of a patient with postoperative inflammation in cataract surgery. Key in the agenda was the use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs); the speakers considered the pros and cons of both and the use of one over the other, as well as presenting the case for a combined regimen to minimize inflammation.

Dr Jose L. Güell, director of the Cornea and Refractive Surgery Unit at the Instituto de Microcirugia Ocular, Barcelona, Spain, discussed the mechanisms, interactions and effects of corticosteroids and NSAIDs in ocular inflammation. He also presented some findings on the use of Mapracorat, a selective glucocorticoid receptor agonist (SEGRA) that was shown to result in less IOP elevation in studies on rabbits, and lower levels of myocilin in simian studies.

Dr Uday Devgan, chief of ophthalmology at the Olive View – UCLA Medical Centre, California, USA, discussed treatment options to best prevent infection and inflammation in both healthy patients and those with underlying diseases. Dr Devgan has studied both treatments; “The pros and cons of NSAIDs: preventing optical infection and inflammation post surgery is important and we’re obviously all doing this. Corticosteroids are the main stay of the treatment control, they can induce less pressure spikes, and NSAIDs are also important, not just as an alternative, but even as a synergistic agent in the treatment of post operative inflammation.”