Petteri Ylinen1,2, Emil Holmström2,3, Ilkka Laine2,4, Juha-Matti Lindholm1,2, Raimo Tuuminen2,5. 1. Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland. 2. Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland. 3. Transplantation Laboratory, University of Helsinki, Helsinki, Finland. 4. Department of Automation and Electrical Engineering, Aalto University, Helsinki, Finland. 5. Kymenlaakso Central Hospital, Unit of Ophthalmology, Kotka, Finland.
Abstract
PURPOSE: To examine the anti-inflammatory efficacy and tolerance between preservative-free dexamethasone (DEX) and diclofenac (DICL) eye drops, and their combination following cataract surgery. METHODS: A randomized, double-blind, prospective single-centre study with 189 eyes of 180 patients undergoing routine cataract surgery. Laser flare meter measurement and spectral-domain optical coherence tomography imaging were conducted before surgery and at the 28-day postoperative visit. Clinical characteristics, surgical parameters and assessment of postoperative symptoms were recorded. RESULTS: Preoperative flare was 9.0 ± 0.6 pu/ms and central retinal thickness (CRT) 269.6 ± 1.9 μm (mean ± SEM). On day 28, flare was 22.1 ± 2.9 pu/ms for DEX, 17.4 ± 2.5 pu/ms for DICL and 13.0 ± 1.6 pu/ms (p < 0.05) for their combination. Central retinal thickness (CRT) increase was 31.5 ± 8.8 μm for DEX, 6.0 ± 0.8 μm (p = 0.001) for DICL, and 3.5 ± 0.5 μm (p < 0.001) for their combination. The incidence of ocular symptoms related to the eye drops was 11% for DEX, 37% for DICL and 34% for their combination (p < 0.001). Clinically significant pseudophakic cystoid macular oedema (PCME) was observed in seven eyes which were all treated with DEX (p < 0.001). CONCLUSION:Diclofenac (DICL), as well as the combination of DEX and DICL, were superior to DEX monotherapy in minimizing CRT change and the incidence of PCME. Combination medication showed no added value compared to DICL monotherapy in uneventful cataract surgery.
RCT Entities:
PURPOSE: To examine the anti-inflammatory efficacy and tolerance between preservative-free dexamethasone (DEX) and diclofenac (DICL) eye drops, and their combination following cataract surgery. METHODS: A randomized, double-blind, prospective single-centre study with 189 eyes of 180 patients undergoing routine cataract surgery. Laser flare meter measurement and spectral-domain optical coherence tomography imaging were conducted before surgery and at the 28-day postoperative visit. Clinical characteristics, surgical parameters and assessment of postoperative symptoms were recorded. RESULTS: Preoperative flare was 9.0 ± 0.6 pu/ms and central retinal thickness (CRT) 269.6 ± 1.9 μm (mean ± SEM). On day 28, flare was 22.1 ± 2.9 pu/ms for DEX, 17.4 ± 2.5 pu/ms for DICL and 13.0 ± 1.6 pu/ms (p < 0.05) for their combination. Central retinal thickness (CRT) increase was 31.5 ± 8.8 μm for DEX, 6.0 ± 0.8 μm (p = 0.001) for DICL, and 3.5 ± 0.5 μm (p < 0.001) for their combination. The incidence of ocular symptoms related to the eye drops was 11% for DEX, 37% for DICL and 34% for their combination (p < 0.001). Clinically significant pseudophakic cystoid macular oedema (PCME) was observed in seven eyes which were all treated with DEX (p < 0.001). CONCLUSION:Diclofenac (DICL), as well as the combination of DEX and DICL, were superior to DEX monotherapy in minimizing CRT change and the incidence of PCME. Combination medication showed no added value compared to DICL monotherapy in uneventful cataract surgery.
Authors: Alejandro Gonzalez-De la Rosa; Jose Navarro-Partida; Juan Carlos Altamirano-Vallejo; Gerardo Daniel Jauregui-Garcia; Ricardo Acosta-Gonzalez; Miguel Angel Ibanez-Hernandez; Guadalupe Fernando Mora-Gonzalez; Juan Armendáriz-Borunda; Arturo Santos Journal: J Ocul Pharmacol Ther Date: 2019-09-05 Impact factor: 2.671
Authors: Alexander Aaronson; Claudia Taipale; Asaf Achiron; Vesa Aaltonen; Andrzej Grzybowski; Raimo Tuuminen Journal: Transl Vis Sci Technol Date: 2021-06-01 Impact factor: 3.283