Difluprednate

Mechanism :

It is an ocular corticosteroid that is mainly antiinflammatory. It reduces edema, capillary dilation and leukocyte migration, deposition of collagen, and scar formation. It inhibits phospholipase A2 through a protein called lipocortins thus inhibiting the inflammatory response and increase intracolor pressure.

Indication :

• Post ophthalmologic surgery(eg: cataract) to reduce swelling and edema.
• Anterior uveitis.

Contraindications :

• Known allergy/hypersensitivity reaction to the drug.

• Ocular infection of the cornea and conjunctiva.

• Glaucoma (especially open-angle) and increased intraocular pressure as corticosteroids increase intraocular pressure further.

• Patients with diabetes mellitus as there is a higher chance of cataract formation.

• In pregnancy, its safety is not established. Although there is minimal systemic absorption of ocular steroids, steroids have an established teratogenic effect and hence risk-benefit should be considered before use. Breastfeeding is considered safe but systemic absorption can be further minimized by applying pressure on the corner of the eye for 1 minute i.e. on the tear duct after instillation.

Dosing :

Adverse Effect :

Uveitis, increased intraocular pressure, keratitis, corneal edema, conjunctival edema, cataract, optic nerve damage, reduced visual acuity, local irritation, abnormal post-op healing, eye pain, and photophobia.