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Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery

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Abstract

Purpose

The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9 % bromfenac, 0.1 % nepafenac, 0.5 % indomethacin, or 0.1 % diclofenac) in addition to topical steroidal treatment with 0.1 % dexamethasone and 0.3 % netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation.

Setting

Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy.

Design

A retrospective 6-month single center study.

Methods

Patients were divided into groups according to treatment with topical drugs for 2 weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac).

Results

Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (−1.3 %, p = 0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3 %, p = 0.04), and did not change in the groups treated with bromfenac (−1.1 %, p = 0.3), indomethacin (+0.1 %, p = 0.19), or diclofenac (+1.2 %, p = 0.74). There were no side effects in any group.

Conclusions

Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.

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References

  1. Miyake K, Ota I, Miyake G, Numaga J (2011) Nepafenac 0.1% versus fluorometholone 0.1% for preventing cystoid macular edema after cataract surgery. J Cataract Refract Surg 37(9):1581–1588

    Article  PubMed  Google Scholar 

  2. Mathys KC, Cohen KL (2010) Impact of nepafenac 0.1% on macular thickness and postoperative visual acuity after cataract surgery in patients at low risk for cystoid macular oedema. Eye (Lond) 24(1):90–96

    Article  CAS  Google Scholar 

  3. Miyake K, Ibaraki N (2002) Prostaglandins and cystoid macular edema. Surv Ophthalmol 47(suppl 1):S203–S218

    Article  PubMed  Google Scholar 

  4. Oka T, Shearer TR, Azuma M (2004) Involvement of cyclooxygenase-2 in rat models of conjunctivitis. Curr Eye Res 29:27–34

    Article  CAS  PubMed  Google Scholar 

  5. Sivaprasad S, Bunce C, Wormald R (2005) Non-steroidal anti-inflammatory agents for cystoid macular oedema following cataract surgery: a systematic review. Br J Ophthalmol 89:1420–1422

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Almeida DR, Johnson D, Hollands H, Smallman D, Baxter S, Eng KT et al (2008) Effect of prophylactic nonsteroidal antiinflammatory drugs on cystoid macular edema assessed using optical coherence tomography quantification of total macular volume after cataract surgery. J Cataract Refract Surg 34:64–69

    Article  PubMed  Google Scholar 

  7. Yavas GF, Oztürk F, Küsbeci T (2007) Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema. J Cataract Refract Surg 33:804–807

    Article  PubMed  Google Scholar 

  8. Baklayan GA, Patterson HM, Song CK, Gow JA, McNamara TR (2008) 24-Hour evaluation of the ocular distribution of 14C-labeled bromfenac following topical instillation into the eyes of New Zealand white rabbits. J Ocul Pharmacol Ther 24(4):392–398

    Article  CAS  PubMed  Google Scholar 

  9. Zaczek A, Artzen D, Laurell CG, Stenevi U, Montan P (2014) Nepafenac 0.1% plus dexamethasone 0.1% versus dexamethasone alone: effect on macular swelling after cataract surgery. J Cataract Refract Surg 40(9):1498–1505

    Article  PubMed  Google Scholar 

  10. Maca SM, Amon M, Findl O, Kahraman G, Barisani-Asenbauer T (2010) Efficacy and tolerability of preservative-free and preserved diclofenac and preserved ketorolac eyedrops after cataract surgery. Am J Ophthalmol 149(5):777–784

    Article  CAS  PubMed  Google Scholar 

  11. Yavas GF, Oztürk F, Küsbeci T (2007) Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema. J Cataract Refract Surg 33(5):804–807

    Article  PubMed  Google Scholar 

  12. McColgin AZ, Heier JS (2000) Control of intraocular inflammation associated with cataract surgery. Curr Opin Ophthalmol 11(1):3–6

    Article  CAS  PubMed  Google Scholar 

  13. Sivaprasad S, Bunce C, Patel N (2012) Non-steroidal antiinflammatory agents for treating cystoid macular oedema following cataract surgery. Cochrane Database Syst Rev 15(2):CD004239

    Google Scholar 

  14. Kim SJ, Flach AJ, Jampol LM (2010) Nonsteroidal antiinflammatory drugs in ophthalmology. Surv Ophthalmol 55(2):108–133

    Article  PubMed  Google Scholar 

  15. Kessel L, Tendal B, Jørgensen KJ, Erngaard D, Flesner P, Andresen JL, Hjortdal J (2014) Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: a systematic review. Ophthalmology 121(10):1915–1924

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy

    Nicola Cardascia, Carmela Palmisano, Tersa Centoducati & Giovanni Alessio

  2. RUO Oftalmologia, Policlinico Consorziale di Bari, p.zza G. Cesare, 11, 70124, Bari, Italy

    Nicola Cardascia

Authors
  1. Nicola Cardascia
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  2. Carmela Palmisano
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  3. Tersa Centoducati
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  4. Giovanni Alessio
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Correspondence to Nicola Cardascia.

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Cardascia, N., Palmisano, C., Centoducati, T. et al. Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery. Int Ophthalmol 37, 1127–1131 (2017). https://doi.org/10.1007/s10792-016-0374-5

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  • DOI: https://doi.org/10.1007/s10792-016-0374-5

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