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Kaori Sekimoto, Kensuke Haruyama, Tetsuri Sugimoto, Yuta Suzuki, Shigehiko Kitano; Efficacy of nepafenac ophthalmic solution in preventing macular edema after cataract surgery in patients with diabetes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1755.
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To evaluate whether topical nepafenac 0.1% solution alone is as efficacious as is topical nepafenac plus betamethasone sodium phosphate 0.1% solution in the outcomes of cataract surgery in patients with diabetes.
Patients who had retinal thickening of less than 300 μm were eligible to enter the study. They were scheduled to undergo phacoemulsification cataract extraction with posterior chamber intraocular lens implantation and were randomized to receive either topical nepafenac 0.1% 3 times daily alone (nepafenac group: n=22) or nepafenac 0.1% 3 times daily plus betamethasone sodium phosphate 0.1% 4 times daily (nepafenac/steroid group: n=26) for approximately six weeks postoperatively. Outcomes were measured by observing best-corrected visual acuity, intraocular pressure, flare in the anterior chamber, and change in macular thickness using optical coherence tomography. The same method was used to compare patients with non-proliferative retinopathy (NPDR).
There was no significant difference in best-corrected visual acuity, intraocular pressure, and flare between the nepafenac group and the nepafenac/steroid group. At 4 weeks, the mean central macular subfield thickness was 255.3 ±25.9 μm in the nepafenac group and 271.7 ±32.5 μm in the nepafenac/steroid group. Up to 4 weeks, there was no significant difference in the macular thickness between the nepafenac group and the nepafenac/steroid group. In patients with NPDR, the increase in macular thicknesses was more inhibited in the nepafenac group than the nepafenac/steroid group at 4 weeks.
This study suggests that topical nepafenac 0.1% alone has effects equivalent to or greater than those of nepafenac 0.1% plus betamethasone sodium phosphate 0.1% in the outcomes of cataract surgery in patients with diabetic retinopathy.
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