June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Subconjunctival dexamethasone for the prevention of cystoid macular oedema in routine cataract surgery: a randomised, controlled trial
Author Affiliations & Notes
  • Enis D Kocak
    Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia
  • Anthony John Hall
    Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia
    Department of Surgery, Monash University, Melbourne, Victoria, Australia
  • David van der Straaten
    Department of Ophthalmology, The Alfred Hospital, Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Enis Kocak, None; Anthony Hall, None; David van der Straaten, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1823. doi:
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      Enis D Kocak, Anthony John Hall, David van der Straaten; Subconjunctival dexamethasone for the prevention of cystoid macular oedema in routine cataract surgery: a randomised, controlled trial. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1823.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Cystoid macular oedema (CMO) is a common complication causing visual loss following cataract surgery. Subconjunctival dexamethasone is used in patients at high risk of developing CMO, however its role in patients with no risk factors for CMO development has not been evaluated. We performed a prospective, randomised, controlled, investigator-masked, single centre clinical trial to test the hypothesis that injection of intra-operative subconjunctival dexamethasone prevents the development of CMO following routine uncomplicated cataract surgery.

Methods : Eyes of patients scheduled to undergo cataract surgery with no known risk factors for development of CMO were randomised to receive either the current standard of care (control group; n = 89) or the current standard of care plus a single subconjunctival depot injection of 1 mg dexamethasone at the conclusion of cataract surgery (dexamethasone group; n = 115). Eyes were excluded from the study if lens capsular disruption occurred at surgery. The primary outcome was the mean change in central macular thickness (CMT), evaluated using optical coherence tomography at 1 week. Secondary outcomes were the incidence of clinical CMO, best-corrected visual acuity (BCVA), intraocular inflammation, and intraocular pressure. An intention to treat analysis was performed using Student’s t- test, the Mann-Whitney U test and Fisher’s exact text.

Results : Mean change in CMT was similar between the two groups (1.3±19.7 µm in the control group compared to 1.5±13.6 µm in the dexamethasone group; P = 0.956). Clinical CMO was present in 2 eyes (2.2%) in the control group and 1 eye (0.9%) in the dexamethasone group (P = 0.582). BCVA at 1 week was 0.10±0.14 logMAR in the control group and 0.10±0.18 logMAR in the dexamethasone group (P = 0.967). There were no statistically significant differences between the groups in the level of post-operative intraocular inflammation (P = 0.279), change in intraocular pressure (P = 0.943) or frequency of adverse events (P = 0.687).

Conclusions : Subconjunctival dexamethasone was not efficacious in preventing CMO or reducing intraocular inflammation following routine cataract surgery. It was not associated with an increase in post-operative complications or adverse effects.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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