Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Objective: The objective of this selective EBM review is to determine whether or not “Is the use of a sustained-release intracanalicular dexamethasone depot an effective treatment for pain reduction following cataract surgery?”
Study Design: A systematic review of three randomized controlled trials (RCTs) all published between 2015 and 2019.
Data Sources: Two RCTs were discovered using PubMed, and one RCT was discovered using Semantic Scholar. The articles were published in peer-reviewed journals in the English language and selected based on relevance to the clinical question.
Outcome Measured: Absence of pain at day 8 following cataract surgery was a primary outcome measured in all three studies using the Ocular Pain Assessment Scale. Patient-rated pain scores ranged 0-10 with higher scores representing severe, disabling pain.
Results: All three studies found that intracanalicular dexamethasone depots provide a significant reduction of ocular pain in patients following cataract surgery compared to the control group. The RCT conducted by Walters et al. (2016) found a NNT of three and a calculated p-value of < 0.0001. This study was found to have a large treatment effect and is statistically significant. The RCT led by Tyson et al. (2019) found a NNT of six and p-value of < 0.0001. This study was found to have a large treatment effect and is statistically significant. Lastly, the RCT led by Walters et al. (2015) found a NNT of three and p-value of < 0.0001. This study was found to have a large treatment effect and is statistically significant. Additionally, in all three studies, patients receiving intracanalicular dexamethasone required the use of additional antiinflammatory rescue drops far less than patients in the placebo group.
Conclusion: All three studies in this review demonstrated that the use of intracanalicular dexamethasone depots provides a statistically significant reduction of pain severity following cataract surgery. This suggests that it is an effective and advantageous treatment method for post-cataract surgery ocular pain.
Montgomery, Camille D., "Is the use of a sustained-release intracanalicular dexamethasone depot an effective treatment for pain reduction following cataract surgery?" (2022). PCOM Physician Assistant Studies Student Scholarship. 616.