A Comparison of Intracameral with Topical Dexamethasone to Control Immediate Post-Surgical Intraocular Inflammation Following Phacoemulsification: A Quasi- Experimental Study

Objective: To compare the effectiveness and safety of preoperative intracameral dexamethasone versus postoperative topical dexamethasone in controlling immediate intraocular inflammation following phacoemulsification.Study Design: Quasi-experimental comparative study.Place and Duration of Study: This study was conducted at the Outpatient Department, Ophthalmology Department, Benazir Bhutto Hospital, Rawalpindi, Pakistan, from August 2024 to November 2024.Methods: Following Institutional Research Forum approval and written informed consent, eligible patients undergoing uncomplicated phacoemulsification were enrolled. Patients were non-randomly allocated into two intervention groups: the intracameral dexamethasone group (0.1 mL of 0.4 mg/mL administered at the end of surgery) and the topical dexamethasone group (0.1% eye drops administered postoperatively). The primary outcome was effectiveness, defined as the absence of, or minimal, anterior chamber inflammation (SUN grade 0 or trace) on postoperative Day 3, assessed by slit-lamp bio microscopy. Safety outcomes included measuring intraocular pressure, assessing anterior chamber flare as a postoperative inflammatory finding, and evaluating for toxic anterior segment syndrome.Results: The mean age of participants was 57.01 ± 5.41 years, with 76.7% aged 50-60 years. Effectiveness was significantly higher in the intracameral dexamethasone group (73.3%) compared to the topical dexamethasone group (23.3%) (P