Betamethasone versus Diclofenac Fallowing strabismus surgery
Elnaz Abedini1 *
- Ankara university
Abstract: Purpose: To compare outcomes of Betamethasone versus Diclofenac in patients after strabismus surgery.
Methods: Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted on MEDLINE, EMBASE, EMCARE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). All randomized controlled trials (RCTs) comparing the outcomes of Betamethasone versus diclofenac poststrabismus surgery were included. An extraction spreadsheet for data collection and Review Manager 5.3 were used for data analysis based on the fixed and random effects models. Discomfort, inflammation, chemosis, conjunctival gap, and intraocular pressure (IOP) were primary outcome measures. Secondary outcomes included conjunctival congestion and injection, discharge, and drop intolerance. Fixed and random effects models were used for the analysis.
Results: Results: Five RCTs enrolling 179 subjects were enrolled. At week 3 postoperatively, there was a significant difference favoring diclofenac over betamethasone in terms of discomfort (mean difference [MD] = −0.35, P = 0.022), conjunctival inflammation (MD = −0.13, P = 0.022), conjunctival chemosis (MD = −0.13, P = 0.040), and postoperative conjunctival gap (MD = −0.20, P = 0.002). In terms of IOP, there were no significant differences. However, no statistically significant differences were noted at weeks 1 and 4 postoperatively. For secondary outcomes, betamethasone had significantly improved conjunctival congestion; however, diclofenac had significantly less injection at the site of muscle attachments at week 3. No significant difference was noted in terms of discharge and drop intolerance.
Conclusion:
Conclusion: Diclofenac is comparable to betamethasone when used following strabismus surgery. However, a significant difference favoring diclofenac in terms of discomfort, inflammation, conjunctival chemosis, and conjunctival gap was only noted at 3 weeks postoperatively. The authors suggest conducting further studies to support the effectiveness of diclofenac as an alternative to corticosteroids following strabismus surgery.
