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R.G. Carassa, C. Ciampi, P. Bettin, L. Pierro, M. Fiori, R. Brancato; Latanoprost, timolol and macular edema in eyes undergoing cataract surgery: a randomized controlled OCT study . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5557.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:to assess whether continuation of latanoprost 0.005% q.d. monotherapy can induce macular edema in glaucomatous eyes undergoing phacoemulsification with IOL implantation, and whether switching to timolol 0.5% b.i.d. may be beneficial to avoid such possible complication. Methods:50 eyes of 50 primary open angle glaucoma patients well controlled on latanoprost 0.005% q.d. monotherapy scheduled for phacoemulsification were randomly assigned to continuing their therapy (group 1, n = 25) or switching to timolol 0.5% b.i.d. (group 2, n = 25) one month before surgery. All eyes underwent optical coherence tomography (OCT) one week before, one week and one month after surgery. Complicated surgeries were to be excluded. An expert observer, masked for treatment and exam timing, evaluated triplicate pooled OCT images both qualitatively and quantitatively (foveal thickness measurement). Continous variables were compared by paired or unpaired t–test for within– and between–group differences respectively. Results:All randomized eyes undewent uneventful phacoemulsification with in–the–bag IOL implantation and were included in the analysis. No significant preoperative differences were detected between the two groups as for age, visual acuity and macular thickness (171.3±20.9 µm vs. 160.5±20.9 µm). One month after surgery VA was 0.86±0.17 in group 1 and 0.86±0.19 in group 2 (n.s.). Qualitative analysis detected 1 case of postoperative macular edema in group 1 and 2 cases in group 2. Foveal thickness was 171.1±21.9 µm vs 163.3±21.9µm at one week, and 169.4±17.1 µm vs 160.6±23.8 µm at one month in group 1 and 2, respectively. No significant difference was found within and between groups. Conclusions:No significant difference was found between the two groups as for macular changes. POAG eyes well controlled on latanoprost monotherapy and scheduled for phacoemusification with IOL implantation do not require to be switched to timolol before surgery.
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