From the Guidelines

Prednisolone acetate is used after cataract surgery to control postoperative inflammation.

Prednisolone acetate is a topical corticosteroid that works by inhibiting the inflammatory response in the eye, reducing swelling, pain, and redness 1.
The exact mechanism of action involves the suppression of the immune system, which reduces the production of pro-inflammatory cytokines and other mediators of inflammation.

The use of topical corticosteroids, such as prednisolone acetate, is a common practice in postoperative care after cataract surgery to prevent cystoid macular edema (CME) and control inflammation 1.
While there is insufficient high-level evidence to compare the effectiveness of topical corticosteroids and NSAIDs in preventing CME, the use of prednisolone acetate is a discretionary decision made by the operating surgeon based on their clinical judgment 1.

The operating ophthalmologist has the ultimate responsibility for postoperative care, including informing patients about medication instructions, activity restrictions, and signs and symptoms of possible complications 1.
Patients should be instructed to follow the prescribed medication regimen, including the use of prednisolone acetate, and to notify the ophthalmologist promptly if problems occur 1.

From the Research

The primary rationale for using prednisolone acetate after cataract surgery is to control inflammation and prevent complications such as cystoid macular edema and anterior chamber inflammation 2, 3, 4.
Prednisolone acetate is a topical corticosteroid that has anti-inflammatory properties, making it an effective treatment for reducing inflammation and preventing postoperative complications 5, 6.

The mechanism of action of prednisolone acetate involves the inhibition of inflammatory cells and the reduction of inflammatory mediators, which helps to decrease inflammation and prevent tissue damage 2, 3.
Prednisolone acetate works by binding to glucocorticoid receptors, which then translocate to the nucleus and regulate the expression of genes involved in inflammation, resulting in a decrease in inflammatory responses 5.

Studies have compared the efficacy and safety of prednisolone acetate with other treatments, such as difluprednate, and found that both agents are safe and effective in controlling inflammation after cataract surgery 5.
However, difluprednate has been shown to be superior in clearing anterior chamber cells and flare at 2 weeks postoperatively, and in terms of corneal clarity at 1 day and 1 week after surgery 5.

Studies have identified risk factors for steroid response after cataract surgery, including longer axial length, younger age, and more preoperative medications in glaucoma patients 6.
Glaucoma patients are also more likely to experience steroid response after cataract surgery, with a relative risk of 3.72 compared to nonglaucoma patients 6.