Prolensa is a prescription eye drop used to treat inflammation and pain after cataract surgery. It contains bromfenac, a nonsteroidal anti-inflammatory drug (NSAID) similar in concept to ibuprofen but formulated specifically for the eye. Your doctor will typically prescribe it as part of your post-surgical recovery plan to keep swelling down and help you heal comfortably.
How Prolensa Works
When your eye undergoes cataract surgery, the tissue responds with inflammation. Your body releases chemical messengers called prostaglandins at the surgical site, which trigger a chain reaction: blood vessels in the eye dilate, fluid leaks into surrounding tissue, and pressure inside the eye can rise. All of this translates to the pain, redness, and swelling you’d otherwise feel after the procedure.
Prolensa works by blocking the enzymes responsible for producing those prostaglandins. Without them, the inflammatory cascade slows dramatically. The result is less swelling inside the eye and significantly less pain during recovery. Because it’s applied directly to the eye rather than taken orally, the drug reaches the inflamed tissue quickly without circulating through the rest of your body in meaningful amounts.
Dosing Schedule and Timeline
Prolensa is a once-daily drop, which makes it one of the simpler post-cataract medications to manage. You start using it one day before surgery, continue on the day of surgery itself, and then keep applying one drop per day for 14 days after the procedure. That adds up to about 16 days of total use.
This once-daily schedule is a practical advantage. Older ophthalmic NSAIDs like diclofenac and some formulations of ketorolac require two to four doses per day. If you’re already juggling multiple post-surgical eye drops (antibiotic drops, for example), fewer doses means fewer chances to mix up your schedule or skip a dose. A review of 67 studies published in the Annals of Pharmacotherapy specifically recommended once-daily options like Prolensa for patients with adherence concerns.
How Well It Works
In the clinical trials that led to FDA approval, Prolensa performed significantly better than placebo drops at both controlling inflammation and eliminating pain. By day 15 of treatment, roughly 48 to 49 percent of patients using Prolensa had completely clear eyes with no measurable inflammation, compared to 17 to 32 percent of patients using placebo drops.
Pain relief was even more striking, and it showed up fast. On the first day after surgery, 76 to 81 percent of patients using Prolensa reported zero pain, compared to 44 to 56 percent of those on placebo. That early pain control matters because the first day or two after cataract surgery tend to be the most uncomfortable.
What to Know About Side Effects
Like all NSAIDs applied to the eye, Prolensa carries a few risks worth understanding. The most notable is the potential for corneal problems. In rare cases, topical eye NSAIDs can thin the cornea or slow the healing of its surface layer. This is more of a concern for people who already have compromised corneas, dry eyes, diabetes, or rheumatoid arthritis, since those conditions make the cornea more vulnerable to begin with.
Prolensa may also slightly increase bleeding time. If you’ve had reactions to aspirin or oral NSAIDs in the past, there’s a possibility of cross-sensitivity, meaning you could react to Prolensa as well. The drops also contain sodium sulfite, a preservative that can trigger allergic reactions in people with sulfite sensitivity (a condition more common in people with asthma).
Instructions for Contact Lens Wearers
You should not put Prolensa in your eyes while wearing contact lenses. The preservative in the drops, benzalkonium chloride, can absorb into soft lenses. Remove your contacts before applying the drop and wait at least 10 minutes before putting them back in. In practice, most people aren’t wearing contacts immediately after cataract surgery anyway, but this matters if you wear a lens in your other eye.
How Prolensa Compares to Other Options
Several NSAID eye drops are available for post-cataract inflammation. The key differences come down to dosing frequency and concentration. Prolensa uses a lower concentration of bromfenac (0.07%) than earlier formulations while still needing only one drop per day. Other options like ketorolac 0.4% require four daily doses, and nepafenac 0.1% requires three. A newer nepafenac formulation (0.3%) also allows once-daily dosing and is the closest equivalent in terms of convenience.
All of these options effectively reduce pain and inflammation after cataract surgery. Your ophthalmologist will choose based on your specific situation, including any allergies, other medications you’re using, and how your eyes have responded to past treatments. The once-daily convenience of Prolensa makes it a common first choice, but it isn’t the only effective option available.