Effect of Non-Steroidal Anti-Inflammatory Drugs on Cystoid Macular Edema in Diabetic Patients after Cataract Surgery

Hyun Koh Chang; Kun Chung Sung

doi:10.3341/jkos.2013.54.3.427

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Chang and Sung: Effect of Non-Steroidal Anti-Inflammatory Drugs on Cystoid Macular Edema in Diabetic Patients after Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2007;54(3):427-431.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2013.54.3.427

Effect of Non-Steroidal Anti-Inflammatory Drugs on Cystoid Macular Edema in Diabetic Patients after Cataract Surgery

Hyun Koh Chang, MD, Kun Chung Sung, MD, PhD

Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea

Address reprint requests to Sung Kun Chung, MD, PhD Department of Ophthalmology, The Catholic University of Korea, Yeouido St. Mary's Hospital #10 63-ro, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1150, Fax: 82-2-761-6869, E-mail: eyedoc@catholic.ac.kr

Received 26 July 2006 Accepted 8 May 2007

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

The present study analyzed the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on cystoid macular edema in diabetic patients after cataract surgery.

Methods

Among 105 eyes of 84 diabetic patients, 43 patients who were administered Pranopulin^® (JW pharmaceutical, Korea) starting 3 days before surgery comprised the experimental group. The control group included 41 patients who were not given Pranopulin^®. The results consisted of macular thickness measurements and total macular volume which were quantified by optical coherence tomography (OCT, Carl Zeiss Meditec).

Results

xMacular thickness of the experimental group was 7.72 ± 13.04 ±m at postoperative 1 month, 7.15 ± 13.62 ±m at postoperative 2 months and was significantly thinner than in the control group (p < 0.05). Macular volume of the experimental group was 0.33 ± 0.49 mm³ at postoperative 1 month, 0.31 ± 0.43 mm³ at postoperative 2 months and was also significantly smaller than in the control group (p < 0.05).

Conclusions

Using NSAIDs prophylactically before cataract surgery can effectively reduce the risk of postoperative cystoid macular edema in diabetic patients.

Keywords: Cystoid macular edema, Nonsteroidal anti-inflammatory drug, Phacoemulsification

References

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Table 1.

Patient demographics and preoperative clinical characteristics

		Control	Pranoprofen	p-value
Age (year)		65.31 ± 12.6	63.47 ± 11.2	0.813
BCVA (log MAR)		0.61 ± 0.43	0.53 ± 0.72	0.216
FT (μm)		216.11 ± 45.73	221.13 ± 49.26	0.738
MV (mm³)		6.84 ± 4.73	6.77 ± 5.01	0.649
Severity of DM (n, %)	NDR	29 (53.7%)	26 (51%)
	NPDR	20 (37.0%)	22 (43.1%)
	PDR	5 (9.3%)	3 (5.9%)

Values are presented as mean ± SD.

SD = standard deviation; BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution; FT = foveal thickness; MV = macular volume; DM = diabetes mellitus; NDR = no diabetic retinopathy; NPDR = non-proliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy.

Table 2.

Changes of Foveal thickness and M acular volume by Postoperative Period

Group	Control	Pranoprofen	p-value
Postoperative 1 month
BCVA (log MAR)	0.22 ± 0.33	0.19 ± 0.24	0.637
∆FT^* (μm)	15.96 ± 18.64	7.72 ± 13.04	0.015
∆MV^† (mm³)	0.65 ± 0.69	0.33 ± 0.49	0.027
Postoperative 2 months
BCVA (log MAR)	0.15 ± 0.22	0.13 ± 0.26	0.721
∆FT^* (μm)	13.24 ± 16.91	7.15 ± 13.62	0.037
∆MV^† (mm³)	0.58 ± 0.43	0.31 ± 0.43	0.036

Values are presented as mean ± SD.

BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Changes of foveal thickness by postoperative period;

^† Changes of macular volume by postoperative period.

Table 3.

Changes of Foveal thickness and M acular volume by severity of DM

		Control	Pranoprofen (+)	p-value
Postoperative 1 month
∆FT^* (μm)	NDR	14.12 ± 10.67	6.34 ± 9.21	0.007
	NPDR	14.09 ± 15.41	8.21 ± 12.39	0.037
	PDR	16.54 ± 20.26	12.41 ± 19.21	0.371
∆MV^† (mm³)	NDR	0.59 ± 0.51	0.33 ± 0.45	0.041
	NPDR	0.68 ± 0.62	0.37 ± 0.51	0.028
	PDR	0.63 ± 0.85	0.49 ± 0.68	0.289
Postoperative 2 months
∆FT^* (μm)	NDR	12.28 ± 11.35	6.12 ± 8.74	0.009
	NPDR	14.81 ± 17.25	7.29 ± 12.21	0.045
	PDR	15.92 ± 19.34	11.48 ± 18.13	0.239
∆MV^† (mm³)	NDR	0.49 ± 0.51	0.28 ± 0.42	0.011
	NPDR	0.54 ± 0.63	0.35 ± 0.55	0.063
	PDR	0.61± 0.76	0.41 ± 0.57	0.612

Values are presented as mean ± SD.

DM = diabetes mellitus; NDR = no diabetic retinopathy; NPDR = non-proliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy.

^* Changes of foveal thickness by postoperative period;

^† Changes of macular volume by postoperative period.

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