Intraocular Pressure Spikes in Difluprednate Ophthalmic Emulsion 0

Purpose • To report intraocular pressure spikes in a consecutive series of 100 uncomplicated

Methods • Retrospective chart review was performed for patients with 5 mm Hg or

Results • In a series of 100 uncomplicated phacoemulsification patients receiving bid dosing of

Results • 60% of IOP spikes were noted on POD 1, 40% by POD

Conclusion • Difluprednate given bid in uncomplicated phacoemulsification patients can cause significant and early

About the Author: Melissa M. Cable, MD, FAAO, FACS, is a board-certified ophthalmologist with

Thank you! Contact Information: Melissa M. Cable, MD, FAAO, FACS Discover Vision Centers 4741

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Intraocular Pressure Spikes in Difluprednate Ophthalmic Emulsion 0. 05% for Postoperative Cataract Inflammation by Melissa M. Cable, FAAO, FACS Discover Vision Centers *The author of this poster has received research funding and travel expense reimbursement from Alcon, Bausch and Lomb, ISTA and Inspire 1

Purpose • To report intraocular pressure spikes in a consecutive series of 100 uncomplicated postoperative cataract patients using difluprednate ophthalmic emulsion 0. 05% bid. • Setting: one surgeon in one clinic 2

Methods • Retrospective chart review was performed for patients with 5 mm Hg or more elevation compared with baseline intraocular pressure. 3

Results • In a series of 100 uncomplicated phacoemulsification patients receiving bid dosing of difluprednate, average 74. 4 years, men and women, 5% of patients responded with ocular hypertension. Of those 5, 100% were previously diagnosed with open angle glaucoma. • Average baseline IOP was 17. 8 mm Hg, average IOP max was 35. 4 mm Hg with a range of 28 -44 mm Hg. Average increase in IOP was 17. 8 mm Hg, with an average percentage increase over baseline of 100. 2%. 4

Results • 60% of IOP spikes were noted on POD 1, 40% by POD 7. IOP was managed by discontinuation of Durezol and/or addition of topical glaucoma meds. • All patients responded to treatment quickly returning to baseline within 1 -2 days. 5

Conclusion • Difluprednate given bid in uncomplicated phacoemulsification patients can cause significant and early elevations of intraocular pressure. Reported rates of ocular hypertension in bid dosing of difluprednate is 34%. [i] The rate of ocular hypertension in this series is 5% with 100% of responders having a history of primary open angle glaucoma. Patients with a history of glaucoma may be more likely to respond to difluprednate even if they are not known steroid responders. [i] Korenfeld, Michael. “Difluprednate: changing the landscape of ocular pharmacology, ” Expert Rev. Ophthalmology, 3(6), 619 -625 (2008). Pp. 619 -624. 6

About the Author: Melissa M. Cable, MD, FAAO, FACS, is a board-certified ophthalmologist with Discover Vision Centers in Kansas City, MO. , specializing in gentle no-stitch cataract surgery, ocular disease and cosmetic procedures. Dr. Cable graduated at the top 5% of her class in both her undergraduate and medical degree programs at Louisiana State University. She completed a residency in ophthalmology at the University of Missouri—Kansas City before joining Discover Vision Centers. Dr. Cable is one of only six partners in the company. With over 30 doctors, 9 locations and 3 surgery centers located in the Kansas City Metro area, Discover Vision Centers has become one of the largest private ophthalmic medical-surgical practices in the United States. 7

Thank you! Contact Information: Melissa M. Cable, MD, FAAO, FACS Discover Vision Centers 4741 S. Cochise Drive Independence, MO 64055 Phone: (816) 478 -1230 Fax: (816) 478 -4413 E-mail: mcable@discovervision. com 8