Ophthalmic
bromfenac sodium sesquihydrate is a topically applied selective
cyclooxygenase (COX)-2 inhibitor. It is similar to
amfenac, except for a
bromine atom at the C(4) of the benzoyl ring position, which markedly affects its in vitro and in vivo potency, extends the duration of anti-inflammatory activity, and enhances its inhibitory effect on COX-2 absorption across the cornea and penetration into ocular tissues. The United States Food and Drug Administration approved
bromfenac in 2005 for the treatment of postoperative
inflammation and the reduction of ocular
pain in patients who have undergone
cataract surgery. Nonsteroidal anti-inflammatory drugs (
NSAIDs), and among them
bromfenac, could be even more effective than
steroids at reestablishing the blood-aqueous barrier, as revealed by flare on
slit-lamp examination and as quantitatively measured using ocular fluorophotometry. Similar to other
NSAIDs, it has a role in inhibiting intraoperative
miosis during
cataract surgery. However,
bromfenac also seems to be useful in other situations, such as
refractive surgery,
allergic conjunctivitis (not useful in
dry eye),
choroidal neovascularization, and even ocular oncology. No reports of systemic toxicity have been published and
bromfenac has good topical tolerance with a low incidence of adverse effects.