The Efficacy and Safety of Nanoparticle-Based Clobetasol Propionate in Managing the Inflammation and Pain in Post-Operative Cataract Patients: A Systematic Review and Meta-Analysis

Anas Alamoudi,1 Abdulaziz Khalid Aldahlawi,2 Naif Almufarriji,1 Ali Saleh Alsudais,3,4 Bandar J Alharbi,5 Basil Khalid A Alomari,3,4 Amer M Alghamdi,6 Omar A Alshehri,1,7 Ahmed Abdullah Aldayel7 1Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia; 2Department of Emergency, King Faisal Complex Hospital, Taif, Saudi Arabia; 3College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 4King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 5Ophthalmology Department, Hera General Hospital, Makkah, Saudi Arabia; 6Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 7Anterior Segment Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCorrespondence: Anas Alamoudi, Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia, Email anasalamoudi99@gmail.comBackground: Nanotechnology-based drug delivery systems are emerging as promising solutions for ocular diseases by improving bioavailability and therapeutic effectiveness. This systematic review and meta-analysis evaluated the efficacy and safety of nanoparticle-based clobetasol propionate (CP) in managing inflammation and pain following cataract surgery.Methods: A comprehensive search across multiple databases identified five randomized controlled trials (RCTs) with a total of 1306 participants. Outcomes measured were anterior chamber cell (ACC) grade, anterior chamber flare (ACF) grade, ocular pain scores, and adverse events. Meta-analysis was conducted using RevMan 5.4.1.Results: Meta-analysis demonstrated significant efficacy of CP in achieving an ACC grade of zero at both 8 days (RR = 2.30, 95% CI [1.81, 2.92], p < 0.00001) and 15 days (RR = 3.06, 95% CI [2.29, 4.09], p < 0.00001), and in reducing ACF grades (RR = 1.87 at day 8; RR = 2.30 at day 15, both p < 0.0001). Pain reduction was significantly superior in the CP group at both intervals (RR = 1.73 day 8; RR = 1.77 day 15, both p < 0.00001). The safety profile of CP showed a marginal trend toward fewer adverse events compared to placebo, but without statistical significance (RR = 0.50, 95% CI [0.24, 1.04], p = 0.06).Conclusion: In summary, nanoparticle-based clobetasol propionate is an effective and well-tolerated drug for managing postoperative inflammation and pain in cataract patients.Keywords: nanotechnology, clobetasol propionate, cataract surgery, inflammation, meta-analysis