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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objectives This study aims to evaluate the effect of two types of topical NSAIDs, nepafenac and bromfenac, in comparison with a placebo on macular edema after phacoemulsification. Background Cystoid macular edema (CME) is the commonest cause of visual decline after phacoemulsification. Design A prospective comparative randomized Open-label clinical trial was performed. Patients and methods A total of 75 patients with senile cataract were included in the present study. Of them, 19 patients were assigned to receive nepafenac 0.3% eye drops, 19 received bromfenac 0.09% eye drops, and 37 received a placebo. The primary outcome measure included the change in the mean spectral-domain optical coherence tomography central subfield thickness at 1 day, 1 week, 1, 2 and 3 months after surgery. The secondary outcome measures included the total macular volume at 1 day, 1 week, 1, 2, 3 months postoperatively; the percentage of eyes in each group that developed CME; and the corrected visual acuity on 6 and 12 weeks after surgery. Results For all retinal thickness measurements, a significant increase in all three groups had been detected, starting from the first week postoperatively. Compared with the control regimen, add-on bromfenac or nepafenac resulted in statistically significant minimization of the changes in the following parameters: change in the macular volume and the central subfield thickness. Conclusion Topical NSAIDs therapy 2 days before surgery has an additive effect in minimizing the risk of pseudophakic CME. Bromfenac has statistically surpassed nepafenac in minimizing the incidence of CME after uneventful phacoemulsification.

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