Expert Perspectives on the Clinical Use of Steroids for Various Ocular Inflammatory Conditions in Indian Settings

Abstract

Background: Although there were clinical studies available regarding the usage of steroids, there were lack of data from clinician’s perspectives. This survey was intended to gather expert perspectives regarding the prescription practice and clinical use of steroids, including specific types and their applications in various inflammatory ocular conditions, as well as in post-cataract surgeries. Methods: This cross-sectional study comprised of 26 multiple-response questionnaires about expert perspectives on steroid prescription practices for ocular conditions and post-cataract surgeries. The survey also collected data on cataract surgery frequency, geographic distribution of cataract development, gender prevalence, and awareness of ocular health in rural and urban populations. Data analysis was conducted using descriptive statistics. Results: The study involved 103 ophthalmic experts in India and majority of the clinicians (36.89%) conducted over 50 cataract surgeries per month, with cataract development reported as most prevalent in suburban (37%) and urban (35%) areas. Most respondents (82.52%) indicated equal prevalence of cataract in both genders, with a higher occurrence observed in patients aged 51-60 years (49.51%). Prednisolone was the preferred steroid after cataract surgery among 64% of the clinicians and for treating anterior (53%) and posterior (64%) segment inflammatory conditions. A substantial proportion of clinicians (46.6%) reported starting non-steroidal anti-inflammatory (NSAID) therapy along with steroids in 21-30% of their patients for managing post-operative inflammation. Most of the experts recommended nepafenac (85%) as the most effective medication for controlling cystoid macular edema (CME). Conclusion: The study highlighted the use of prednisolone as the preferred steroid after cataract surgery and for various inflammatory conditions. Loteprednol emerged as a favored choice for ocular surface inflammation and allergy-associated conditions, while nepafenac was recommended for controlling CME.