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Rithwick Rajagopal, Kevin Blinder, Gaurav K. Shah; Adjunctive Therapy With Topical Nepafenac After Membrane Stripping Surgery For Macular Edema Due To Epiretinal Membranes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):906.
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To assess functional and anatomical outcomes of therapy with topical nepafenac 0.1% after membrane stripping in the reduction of macular edema from idiopathic epiretinal membranes.
Retrospective review of patients who underwent pars plana vitrectomy and combined epiretinal membrane and internal limiting membrane stripping performed by two surgeons at one institution for the treatment of macular edema associated with idiopathic epiretinal membranes. Patients received either a standard postoperative treatment regimen, including antibiotic and steroid eye drops, or topical nepafenac in addition to standard therapy. Primary outcome measures were change in visual acuity (logMAR) and mean change in macular thickness as measured by optical coherence tomography at postoperative month three.
Nineteen patients met eligibility criteria for the study. Ten received a standard postoperative regimen and nine received nepafenac in addition to standard therapy. At month three, mean improvement in visual acuity was -0.1 logMAR in the standard therapy group and -0.16 logMAR in the nepafenac group (p=0.56, ANOVA). Mean change in macular thickness was -43.7 microns in the standard group and -81.3 microns in the nepafenac group (p=0.39, ANOVA). Approximately half of patients in each group were phakic at the time of surgery and developed a vitrectomy-induced cataract.
Nepafenac failed to show a statistically significant difference in visual acuity or macular thickness outcomes after membrane stripping surgery for macular edema due to epiretinal membranes compared to standard therapy. Although anatomic results tended to be more favorable with nepafenac, a longer follow-up interval with a larger patient series would better assess the impact of this medication on visual recovery and decrease in macular thickness.
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