Abstract
The purpose of the current study was to compare outcomes of diclofenac versus corticosteroids fol-lowing strabismus surgery. A systematic review and meta-analysis were performed in line with the Pre-ferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search was performed to include comparative studies of diclofenac versus corticosteroids following strabismus surgery. The analysis was based on fixed and random effect models. Primary outcomes included discomfort, chemosis, in-flammation, conjunctival gap, intraocular pressure, and conjunctival injection. Secondary outcomes were con-junctival congestion, discharge, and drop intolerance. Eight studies with a sample of 469 eyes were included. At weeks 1 and 4 postoperatively, there were no statisti-cally significant differences between the diclofenac and corticosteroid groups, except for conjunctival injection at week 1 (mean difference [MD] =-0.21, P = .04) favor-ing diclofenac. Interestingly, all primary outcomes sig-nificantly favored diclofenac at week 2: discomfort (MD =-0.34, P = .03), conjunctival chemosis (MD =-0.16, P = .04), conjunctival inflammation (MD =-0.16, P = .02), conjunctival gap (MD =-0.17, P= .002), intraocular pres-sure (MD =-2.53, P < .00001), and conjunctival injection (MD =-0.30, P= .03). Moreover, conjunctival congestion was significantly improved for dexamethasone, where-as discharge and drop intolerance was not statistically different. Diclofenac is comparable to various corti-costeroids when used following strabismus surgery. However, it is important to note that diclofenac yielded significant improvements in discomfort, conjunctival chemosis, inflammation, conjunctival gap, intraocular pressure, and conjunctival injection, mainly at 2 weeks postoperatively. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.]