Comparison of topical steroids with non-steroidal anti-inflammatory drugs in preventing inflammatory complications following Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy in patients with posterior capsular opacification

Objectives: Posterior capsular opacification is the most common delayed complication of cataract surgery. The Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG laser) posterior capsulotomy restores vision but may cause post-operative inflammation and transient intraocular pressure (IOP) rise. The optimal anti-inflammatory regimen remains uncertain. The aim of this study is to compare topical steroids (0.1% dexamethasone with 0.5% moxifloxacin) and topical non-steroidal anti-inflammatory drugs (NSAIDs) (0.1% nepafenac) in preventing inflammatory complications following Nd:YAG capsulotomy. Materials and Methods: The present study is a prospective longitudinal comparative study done at a tertiary care teaching hospital in Ahmedabad, Gujarat, India. One hundred and two eyes of 86 patients undergoing Nd:YAG capsulotomy were alternately allocated into two groups. Group I received topical dexamethasone (tapered over 20 days) and Group II received topical nepafenac for 15 days. Follow-up was conducted at 3–4 days, 7–10 days and 21–30 days. Outcome measures included best corrected visual acuity (BCVA), IOP and inflammatory complications. Student’s t-test and Pearson Chi- square test were applied; p < 0.05 was considered significant. Results: IOP was significantly higher in the steroid group ( p = 0.023) at first follow-up, with no difference thereafter. Inflammatory complications showed no significant intergroup difference. Both groups improved significantly in BCVA, with greater visual recovery in the NSAID group ( p = 0.001). Conclusion: Topical NSAIDs provide comparable inflammation control with less early IOP elevation and better visual recovery, supporting their use as first-line therapy after Nd:YAG capsulotomy.