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Jeong, Shin, Seo, and Lee: Comparison of 1% Prednisolone and 0.1% Bromfenac Solutions for Preventing Macular Edema after Cataract Surgery
Original Article

J Korean Ophthalmol Soc 2016;57(12):1834-1839.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.12.1834

Comparison of 1% Prednisolone and 0.1% Bromfenac Solutions for Preventing Macular Edema after Cataract Surgery

Hyun Kyo Jeong, MD1, Woo Beom Shin, MD1, Kyoung Yul Seo, MD, PhD2, Jeihoon Lee, MD1

1Siloam Eye Hospital, Seoul, Korea

2Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Jeihoon Lee, MD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0700, Fax: 82-2-2650-0725 E-mail: genialtoday@siloam.co.kr

Received 8 September 2016       Revised 13 November 2016       Accepted 29 November 2016

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the clinical effectiveness of 1% Prednisolone acetate ophthalmic solution and 0.1% Bromfenac sodium hydrate ophthalmic solution on prevention of cystoid macular edema after cataract surgery.

Methods

A retrospective chart review of 349 patients who received phacoemulsification with intraocular lens implantation in Severance Hospital from July 2013 to January 2016 was performed. In these patients, 192 eyes received 1% Prednisolone acetate ophthalmic solution, and 157 eyes were treated with topical 0.1% Bromfenac sodium hydrate ophthalmic solution. The incidence and severity of cystoid macular edema (CME) were evaluated by retinal foveal thickness on optical coherence tomography for patients who showed best corrected visual acuity (BCVA) less than 0.5 (log MAR ≥ 0.3).

Results

There was no significant difference between the two groups in age (p = 0.708), sex (p = 0.977), or the side of operated eye (p = 0.443). The two groups showed BCVA 0.04 ± 0.09 (Steroid group) and 0.03 ± 0.07 (nonsteroidal anti-inflammatory drug [NSAID] group) at 1 month after the surgery and the difference was not significant (p = 0.947). One eye in the topical steroid group had cystoid macular edema, and 3 eyes in the steroid group showed elevated intraocular pressure (IOP) over 30 mm Hg. There were no IOP elevations or macular edema in the NSAID group.

Conclusions

The results showed that 0.1% Bromfenac sodium hydrate ophthalmic solution had a similar effect to 1% Prednisolone acetate ophthalmic solution on preventing CME after cataract surgery. This indicates that topical NSAID can be considered along with topical steroids in order to prevent CME after cataract surgery.

Keywords: Cataract, Cystoid macular edema (CME), Nonsteroidal anti-inflammatory drug (NSAIDs)

References

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Figure 1.
Comparison of best-corrected visual acuity (BCVA, log MAR) between steroid group and nonsteroidal anti-in-flammatory drug (NSAID) group over time.
jkos-57-1834f1.tif
Figure 2.
Comparison of intraocular pressure (IOP) between steroid group and nonsteroidal anti-inflammatory drug (NSAID) group over time.
jkos-57-1834f2.tif
Table 1.
Patient and study variables
  Group (n, %)
 p-value
Steroid NSAID
No. of eyes 192 157  
Age (years) 67.11 ± 11.13 67.10 ± 11.51 0.708*
Sex      
 Male 80 (41.67) 66 (42.04) 0.977†
 Female 112 (58.33) 91 (57.96)  
Laterality      
 Right 88 (45.83) 78 (49.68) 0.443†
 Left 104 (54.17) 79 (50.32)  
Preop. BCVA (log MAR) 0.46 ± 0.50 0.38 ± 0.40 0.158*
Preop. IOP (mm Hg) 14.13 ± 3.09 14.31 ± 2.65 0.411*

Values are presented as mean ± SD or number (%). NSAID = nonsteroidal anti-inflammatory drug; Preop. = preoperative; BCVA = best corrected visual acuity; IOP = intraocular pressure.

* Mann-Whitney U-test

† Pearson's Chi-squared test.

Table 2.
Postoperative complications
Variables Group (n, %)
 p-value*
Steroid NSAID
IOP spike 3 (1.57) 0 0.115
Cystoid macular edema 1 (0.52) 0 0.365
Keratopathy 0 1 (0.64) 0.270
BRVO 1 (0.52) 0 0.365

Values are presented as n (%) unless otherwise indicated. NSAID = nonsteroidal anti-inflammatory drug; IOP = intraocular pressure; BRVO = branch retinal vein occlusion.

* Pearson's Chi-squared test.

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