Nepafenac may not increase IOP

This prospective, randomized study of patients with normal eyes found that nepafenac eye drops do not appear to increase IOP, contrary to what the product’s package insert indicates.

Subjects included 327 patients with bilateral cataract. One eye of each patient was treated with nepafenac 0.1% eye drops (Nevanac; Alcon Labs) three times a day, while the contralateral eye served as a control.

The authors measured IOP at baseline and at one and two months postop, and found a statistically significant IOP reduction in both groups but no statistically significant difference between the two eyes. The mean IOP at baseline in the treated and control eyes was 13.8 ± 2.5 mm Hg and 13.4 ± 3.0 mm Hg, respectively, which dropped to 12.0 ± 2.0 mm Hg and 12.1 ± 1.5 mm Hg, respectively, at the end of eight weeks.

Only one eye in the treated group and two in the control group had a pressure rise greater than 4 mm Hg, which contradicts the package insert stating IOP rise occurs in 5 to 10 percent of patients.

They conclude that these results show that nepafenac can be used as an alternative to steroid medications in patients in whom steroid responsiveness is low and a strong anti-inflammatory effect is not needed.