A Comparison of Intracameral with Topical Dexamethasone to Control Immediate Post-Surgical Intraocular Inflammation Following Phacoemulsification: A Quasi- Experimental Study

Abstract

Objective: To compare the effectiveness and safety of preoperative intracameral dexamethasone versus postoperative topical dexamethasone in controlling immediate intraocular inflammation following phacoemulsification.
Study Design: Quasi-experimental comparative study.
Place and Duration of Study: This study was conducted at the Outpatient Department, Ophthalmology Department, Benazir Bhutto Hospital, Rawalpindi, Pakistan, from August 2024 to November 2024.
Methods: Following Institutional Research Forum approval and written informed consent, eligible patients undergoing uncomplicated phacoemulsification were enrolled. Patients were non-randomly allocated into two intervention groups: the intracameral dexamethasone group (0.1 mL of 0.4 mg/mL administered at the end of surgery) and the topical dexamethasone group (0.1% eye drops administered postoperatively). The primary outcome was effectiveness, defined as the absence of, or minimal, anterior chamber inflammation (SUN grade 0 or trace) on postoperative Day 3, assessed by slit-lamp bio microscopy. Safety outcomes included measuring intraocular pressure, assessing anterior chamber flare as a postoperative inflammatory finding, and evaluating for toxic anterior segment syndrome.
Results: The mean age of participants was 57.01 ± 5.41 years, with 76.7% aged 50-60 years. Effectiveness was significantly higher in the intracameral dexamethasone group (73.3%) compared to the topical dexamethasone group (23.3%) (P<0.001). Postoperative inflammatory findings and safety outcomes, including raised intraocular pressure and toxic anterior segment syndrome, were infrequent and did not differ significantly between groups.
Conclusion: Intracameral dexamethasone is more effective than topical dexamethasone for controlling immediate postoperative intraocular inflammation following phacoemulsification, without an increased risk of adverse outcomes. Its targeted delivery provides reliable early control of inflammation while reducing dependence on postoperative topical therapy.

How to cite this: Khanam H, Kamran K MB, Akhter S, Hareem Z, Niazi FAK. A Comparison of Intracameral with Topical Dexamethasone to Control Immediate Post-Surgical Intraocular Inflammation Following Phacoemulsification: A Quasi-Experimental Study. Life and Science. 2026; 7(1): 73-79.doi: http://doi.org/10.37185/LnS.1.1.1096