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Preoperative anti‐inflammatory treatment of diabetic patients does not improve recovery from cataract surgery when postoperatively treated with a combination of prednisolone acetate and nepafenac
Author(s) -
Danni Reeta,
Viljanen Antti,
Aaronson Alexander,
Tuuminen Raimo
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14018
Subject(s) - medicine , cataract surgery , surgery , prednisolone , randomized controlled trial , diabetes mellitus , prospective cohort study , ophthalmology , endocrinology
Purpose To examine preoperative anti‐inflammatory treatment on recovery from cataract surgery in eyes of diabetic patients. Methods A Prospective randomized clinical trial. One hundred and three eyes of 103 patients with diabetes undergoing routine cataract surgery were randomized (1:1) not to receive any preoperative anti‐inflammatory medication or to receive preoperative topical anti‐inflammatory medication with a combination of prednisolone acetate (10 mg/ml) and nepafenac (1 mg/ml). All eyes received postoperative anti‐inflammatory combination therapy for 3 weeks. Recovery from surgery was recorded by a structured home questionnaire. Clinical outcome parameters were recorded at 28 days and 3 months. Results Patient age and gender distribution, and all baseline ophthalmic and systemic parameters were comparable between the study groups. After surgery, conjunctival injection lasted 2.4 ± 1.7 days (mean ± SD ) and irritation of the eye 3.3 ± 3.9 days in eyes without preoperative treatment, when compared to 1.6 ± 1.6 days (p = 0.067) and 2.4 ± 4.0 days (p = 0.431), respectively, in eyes with preoperative treatment. At 28 days, central subfield macular thickness ( CSMT ) increased 2.2 ± 20.2 μ m in eyes without preoperative treatment, when compared 0.1 ± 25.2 μ m (p = 0.670) in eyes with preoperative treatment. At 3 months, the respective CSMT change from baseline was −1.5 ± 26.9 μ m and −3.4 ± 26.2 μ m (p = 0.762). None of the eyes were reported with pseudophakic cystoid macular oedema ( PCME ) in either group. Conclusion Lack of preoperative anti‐inflammatory treatment does not impair recovery from surgery or predispose diabetic patients to increased risk of PCME in eyes postoperatively treated with combination therapy of prednisolone acetate and nepafenac.