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Salim Ben Yahia, Rim Kahloun, Nesrine Abroug, Imen Ksiaa, Imen Kaibi, Bechir Jelliti, Moncef Khairallah; Comparative Effect of Topical Diclofenac and Topical Dexamethasone on Blood-aqueous Barrier Breakdown and Postoperative Pain following Retinal Detachment Surgery. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5095.
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To compare the effect of topical diclofenac and topical dexamethasone on blood-aqueous barrier breakdown and postoperative pain following surgery for rhegmatogenous retinal detachment (RRD).
The study included 40 eyes of 40 patients treated for RRD. Patients underwent scleral buckling (N=28) or 20-gauge pars plana vitrectomy (PPV) (N=12). For each surgical technique, patients were postoperatively divided into two groups: the first group was treated with topical dexamethasone phosphate 0.1% four times daily for 28 days; the second group was treated with topical diclofenac sodium 0.1% three times daily for 28 days. The inflammatory reaction in the anterior chamber was measured with laser flare photometry preoperatively and 1, 7, 14, 28, and 90 days postoperatively. Pain level was evaluated with Scott’s visual analogue scale at day 1, 7, 14, and 28 postoperatively.
For patients treated with scleral buckling, there was no significant difference between the two groups regarding the mean aqueous flare value at day 1 (p=0.096), day 7 (p=0.435), day 14 (p=0.510), day 28 (p=0.583), and day 90 (p=0.423). The group receiving diclofenac had significantly lower pain score at days 7, 14, and 28 (p=0.048, p=0.017 and p=0.028, respectively). For patients treated with PPV, there was no significant difference between the two groups regarding the mean aqueous flare value at day 1 (p=0.400), day 7 (p=0.728), day 14 (p=0.843), day 28 (p=0.939), and day 90 (p=0.568). Patients receiving diclofenac had significantly lower pain score at days 7, 14, and 28 (p=0.032, p=0.030 and p=0.023, respectively).
Topical diclofenac seems to be as potent as topical dexamethasone in managing inflammatory reaction induced by surgery for RRD with better analgesic effect.
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