Nevanac

A single surgeon (J.S.M.C.) performed all the surgeries under topical anesthesia (oxybuprocaine 0.4%) and intracameral preservative-free lidocaine 2%. Preoperatively, nepafenac ophthalmic suspension 0.1% (Nevanac, Alcon Laboratories, Inc.) and tropicamide 0.5%/phenylephrine hydrochloride 0.5% (Mydrin-P, Santen Pharmaceutical Co., Ltd.) were applied to the eye. A 2.25 mm clear corneal incision was created superiorly or temporally with a 2.2 mm microkeratome. DisCoVisc ophthalmic viscosurgical device (Alcon Laboratories, Inc.) was injected into the anterior chamber, and a manual continuous curvilinear capsulorhexis was created using forceps. After hydrodissection and nucleus splitting, coaxial phacoemulsification was performed using a Centurion Vision System (Alcon Laboratories, Inc.). The residual cortex was irrigated and aspirated. The posterior capsule was polished using a coaxial system. Clear corneal incision and continuous curvilinear capsulorhexis in some cases were created using femtosecond laser. All the IOLs were placed in the capsular bag.

All patients were instructed to use moxifloxacin eye drops (Vigamox®; Alcon Laboratories, Inc, Fort Worth, TX, USA) four times a day and 0.1% nepafenac ophthalmic suspension (Nevanac®; Alcon Laboratories, Inc, Fort Worth, TX, USA) three times a day for 3 days before the operation. Following the operation, they were instructed to use moxifloxacin four times a day and 0.1% betamethasone sodium phosphate eye drops (Rinderon, Shionogi Pharmaceutical, Osaka, Japan) four times a day for 2 weeks and bromfenac ophthalmic solution 0.09% (Xibrom™, ISTA Pharmaceuticals Inc, Irvine, CA, USA) twice a day for 1 month.

Patients were randomly allocated 1:1 to receive bromfenac 0.09% (Zebesten ofteno; Sophia Laboratories SA de CV, Guadalajara, Jalisco, Mexico) or nepafenac 0.1% (Nevanac; Alcon Laboratories, Inc., Fort Worth, TX, USA) using a computer that generated a list of random numbers. The morning of the scheduled cataract surgery, a nurse was instructed to instill five drops into each patient’s eye in the hour before surgery. After surgery the subjects instilled one drop of study drug topically in the conjunctival sac of the eye three times daily for 30 days. Investigators were masked to the study medication. Because the active control bottle (Nevanac) was visibly different compared to the investigational bottle, a designee at each study site, other than the investigator, was responsible for dispensing the study treatment. Attempts were made to mask the subjects by removing commercial labeling, replacing it with identical investigational labels, and packaging in identical kit boxes.