Petteri Ylinen1,2, Claudia Taipale1,2, Juha-Matti Lindholm1,2, Ilkka Laine1,3, Emil Holmström1,4, Raimo Tuuminen1,5. 1. Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland. 2. Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland. 3. Department of Automation and Electrical Engineering, Aalto University, Helsinki, Finland. 4. Transplantation Laboratory, University of Helsinki, Helsinki, Finland. 5. Unit of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland.
Abstract
PURPOSE: Current cataract surgery guidelines recommend routine use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing pseudophakic cystoid macular oedema (PCME). Here, we compare the clinical efficacy and tolerability of two potent NSAIDs, nepafenac and preservative-free diclofenac following cataract surgery. METHODS: Randomized, double-blind, prospective single-centre study. Ninety-six eyes of 95 patients undergoing routine cataract surgery were randomized 1:1 either to nepafenac (Nevanac, 1 mg/ml) or diclofenac (Dicloabak, 1 mg/ml) for 3 weeks. Seventy-three patients accounting for 73 eyes completed the entire follow-up. Aqueous flare and central retinal thickness (CRT) analysis were conducted preoperatively and at control visits 28 days and 3 months after surgery. A structured home questionnaire and interview were used to record any adverse effects of the topical medications, subjective visual recovery and the dispenser's ease of use. RESULTS: No differences were observed between the groups for aqueous flare, CRT, speed of recovery or visual acuity gain. Seven patients (16%) on nepafenac and 20 patients (48%) on preservative-free diclofenac reported symptoms related to topical use of NSAID medications (p = 0.001). CONCLUSION: No differences in clinical efficacy were found between potent NSAIDs, while tolerability might be an issue.
RCT Entities:
PURPOSE: Current cataract surgery guidelines recommend routine use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing pseudophakic cystoid macular oedema (PCME). Here, we compare the clinical efficacy and tolerability of two potent NSAIDs, nepafenac and preservative-free diclofenac following cataract surgery. METHODS: Randomized, double-blind, prospective single-centre study. Ninety-six eyes of 95 patients undergoing routine cataract surgery were randomized 1:1 either to nepafenac (Nevanac, 1 mg/ml) or diclofenac (Dicloabak, 1 mg/ml) for 3 weeks. Seventy-three patients accounting for 73 eyes completed the entire follow-up. Aqueous flare and central retinal thickness (CRT) analysis were conducted preoperatively and at control visits 28 days and 3 months after surgery. A structured home questionnaire and interview were used to record any adverse effects of the topical medications, subjective visual recovery and the dispenser's ease of use. RESULTS: No differences were observed between the groups for aqueous flare, CRT, speed of recovery or visual acuity gain. Seven patients (16%) on nepafenac and 20 patients (48%) on preservative-free diclofenac reported symptoms related to topical use of NSAID medications (p = 0.001). CONCLUSION: No differences in clinical efficacy were found between potent NSAIDs, while tolerability might be an issue.
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