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Nicola Cardascia, Carmela Palmisano, Teresa Centoducati, Giovanni Alessio; Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in the prevention of cystoid macular edema after cataract surgery.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):671.
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To compare topical-NonSteroidal AntiInflammatory Drugs (t-NSAID) (bromfenac 0,09%, nepafenac 0.1%, indometacine 0.5%, diclofenac 0.1%) associated with topical steroidal antiinflammatory drug (fixed combination of dexamethasone 0.1%and netilmicin 0.3% ) in preventing cystoid macular edema (CME) after small-incision cataract extraction with foldable intraocular lens (IOL) implantation.
Retrospective six months single-center study. Patients were divided in groups according to topical therapy prescribed for 2 weeks after phacoemulsification with foldable IOL implantation. The incidence of CME was evaluated by retinal foveal thickness variations on SD optical coherence tomography. All patients received topical therapy of fixed combination of dexamethasone and netilmicin. According to the association with t-NSAID we identified 5 groups: bromfenac , nepafenac, indometacine , diclofenac, dexamethasone-netilmicin alone.
Thirteen patients received bromfenac , 15 nepafenac, 12 indometacine, 8 diclofenac and 6 dexamethasone-netilmicin alone. Four weeks postoperatively, foveal thickness was reduced in all groups except in the one treated with diclofenac (P=0.02). Dexamethasone-t-NSAID association was more efficacious than dexamethasone alone in macular thickness restoration . After the forth week macular thickness variations were: bromfenac -1.1%, nepafenac -1.3%, indometacine 0.1%, diclofenac 1.7%, dexamethasone 8.7%. There were no side effects in all groups.
t-NSAID enhanced the efficacy of steroid to reduce post-operative macular edema, except in eyes treated with diclofenac .
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