Comparison of the Effects of Prophylactic Nonsteroidal Anti-inflammatory Drugs on Macular Edema After Cataract Surgery

Bo Young Chun; Su Yeon Kang; Jong Suk Song; Hyo Myung Kim

doi:10.3341/jkos.2010.51.7.935

Journal List > J Korean Ophthalmol Soc > v.51(7) > 1008856

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Chun, Kang, Song, and Kim: Comparison of the Effects of Prophylactic Nonsteroidal Anti-inflammatory Drugs on Macular Edema After Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2010;51(7):935-940.

Published online: 31 August 2010

DOI: https://doi.org/10.3341/jkos.2010.51.7.935

Comparison of the Effects of Prophylactic Nonsteroidal Anti-inflammatory Drugs on Macular Edema After Cataract Surgery

Bo Young Chun, MD, Su Yeon Kang, MD, Jong Suk Song, MD, PhD, Hyo Myung Kim, MD, PhD

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

Address reprint requests to Hyo Myung Kim, MD, PhD, Department of Ophthalmology, Korea University Anam Hospital #126-1 Anam 5-dong, Seongbuk-gu, Seoul 136-705, Korea Tel: 82-2-920-5520, Fax: 82-2-924-6820, E-mail: hyomkim@hanmail.net

Received 9 October 2009 Accepted 14 May 2010

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 evaluate and compare the efficacy of prophylactic administration of topical nonsteroidal anti-inflammatory (NSAID) drugs on macular edema (ME) following cataract surgery.

Methods

The present open-label non-masked randomized (random number assignment) study was comprised of 90 eyes. Thirty eyes were administered Diclofenac sodium 0.1%, and 30 eyes were administered Pranoprofen 0.1% starting three days before surgery and continued for one month after surgery. The remaining 30 eyes made up the control group. The results consisted of the measurements of foveal thickness (FT), macular thickness (MT), and total macular volume (TMV), which were quantified by optical coherence tomography (OCT, Carl Zeiss Meditec) before and one month after phacoemulsification surgery.

Results

At one month, there were statistically significant differences in FT in the Diclofenac group (0.48±10.9 μ m) and the Pranoprofen group (1.87±14.7 μ m) (p＜0.05) compared with the control group (11.65±18.6 μ m). In addition, there was a statistically significant difference in MT between the control group (71.06±90.8 μ m) and the Diclofenac group (15.19±36.1 μ m) (p＜0.05). However, no statistical difference in MT was noted between the control group and the Pranoprofen group (27.57±70.93 μ m). Between the control group and the NSAID groups, only the Diclofenac group showed statistical differences in TMV throughout the observational period.

Conclusions

Used prophylactically after cataract surgery, the NSAIDS eye drops were effective in reducing postoperative ME.

Keywords: Nonsteroidal anti-inflammatory drug (NSAID), Pseudophakic macular edema

References

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Table 1.

Patient demographics and clinical characteristics

	Control (n=30)	Diclofenac (+)(n=30)	Pranoprofen (+)(n=30)	P value^*
Age (yr)	63.6±9.41	67.0±8.16	65.1±9.63	0.579
BCVA (Log MAR) (mean± SD)	0.37±0.72	0.31±0.62	0.41±0.72	0.216
Nuclear sclerosis (0∼+4)	+ 2.35±1.36	+ 2.12±1.16	+ 2.78±1.12	0.651
HTN	6	7	5
Glaucoma	2	1	2

BCVA=best corrected visual acuity; LogMAR=logarithm of the minimum angle of resolution; SD=standard deviation; HTN=hypertension

^* ANOVA t-test.

Table 2.

Patient postoperative profiles

Group	Control (n=30)	Diclofenac (+) (n=30)	Pranoprofen (+) (n=30)	P value^*
BCVA (Log MAR) (mean± SD)	0.065±0.85	0.065±0.82	0.065±0.85	0.963
Discomfort scale	0.52±0.84	2.87±1.45	2.32±1.22	0.048
ΔFT^† (μm)	11.65±18.6	0.48±10.9	1.87±14.7	0.007
ΔMT^† (μm)	71.06±90.8	15.19±36.1	27.57±70.93	0.015
ΔTMV^‡ (mm³)	0.31±0.42	0.06±0.17	0.14±0.33	0.027

BCVA=best corrected visual acuity

LogMAR=logarithm of the minimum angle of resolution;

SD=standard deviation

^* ANOVA test

^† Foveal thickness, Macular thickness

^‡ Total macular volume.

Table 3.

Post Hoc multiple comparisons of postoperative change in foveal thickness, macualr thickness and total macular volume (P value)

Variable	Group	Control (n=30)	Diclofenac(+) (n=30)	Pranoprofen(+) (n=30)
Δ Foveal thickness(μm)	Control	×	0.005	0.016
	Diclofenac (+)	0.005	×	0.340
	Pranoprofen (+)	0.016	0.340	×
Δ Macularr thickness (μm)	Control	×	0.010	0.042
	Diclofenac (+)	0.010	×	0.475
	Pranoprofen (+)	0.042	0.475	×
ΔTotal macular volume (mm³)	Control	×	0.014	0.078
	Diclofenac (+)	0.014	×	0.435
	Pranoprofen (+)	0.078	0.435	×

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