Bromfenac

How it works

It inhibits cyclo-oxygenase, reducing prostaglandin synthesis and thereby controlling ocular inflammation and associated pain after surgery.

Prescribing in practice

• Topical ocular NSAIDs can cause corneal complications including epithelial breakdown, thinning, ulceration and, rarely, perforation, particularly with prolonged use or in at-risk eyes.
• Use with caution in patients with known hypersensitivity to aspirin or other NSAIDs and in those with bleeding tendencies.
• Caution is advised in diabetes, ocular surface disease, rheumatoid arthritis and repeat ocular surgery, which increase the risk of corneal adverse effects.

Monitoring

Monitor the cornea for signs of epithelial breakdown or thinning, especially with extended use or in eyes with predisposing surface disease.

Counselling the patient

• Report any worsening eye pain, redness or deterioration in vision promptly.
• Remove soft contact lenses before instilling and wait before reinserting them.
• Do not exceed the prescribed treatment duration without ophthalmology review.

Evidence & guidelines

Topical NSAIDs are an established treatment for postoperative ocular inflammation and for prophylaxis of cystoid macular oedema after cataract surgery.