Management of ocular inflammation and pain following cataract surgery: focus on bromfenac ophthalmic solution

Hyung Cho, Kenneth J Wolf, Eric J Wolf, Hyung Cho, Kenneth J Wolf, Eric J Wolf

Abstract

Recently, several new ophthalmic NSAID products have been introduced for commercial use in the United States. The purpose of this review is to briefly overview the ophthalmic NSAIDs currently in use and to discuss the management of postoperative ocular inflammation and pain following cataract surgery with a particular focus on bromfenac ophthalmic solution 0.09%. Bromfenac ophthalmic solution 0.09% is indicated for the reduction of ocular pain and inflammation following cataract surgery. Studies have shown that bromfenac ophthalmic solution 0.09% has equivalent efficacy to the other topical NSAIDs in reducing postsurgical inflammation and controlling pain. The unique chemical structure of bromfenac makes it both a potent inhibitor of the COX-2 enzyme and a highly lipophilic molecule that rapidly penetrates to produce early and sustained drug levels in all ocular tissues. Clinically, these pharmacokinetic features are manifested in a rapid reduction of postsurgical inflammation and pain with bid dosing. Bromfenac ophthalmic solution 0.09% is a versatile agent and is effective when used as either monotherapy or as an adjunct therapy to steroids.

Keywords: bromfenac; ocular inflammation; ophthalmic NSAIDs.

Figures

Figure 1
Figure 1
Prostaglandin and thromboxan biosynthesis. After FitzGerald and Patrono 2001. Abbreviations: COX, cyclooxygenase; coxibs, COX-2 inhibitors; PG, prostaglandin; TxA2, thromboxane A2; NSAID, nonsteroidal anti-inflammatory drug; ASA, aspirin.
Figure 2
Figure 2
Chemical structure of bromfenac.
Figure 3
Figure 3
Deamination of nepafenac to the active compound amfenac.

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