Intraindividual comparison of nepafenac 0.3% for the prevention of macular edema after phacoemulsification (original) (raw)
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Journal of Rawalpindi Medical College
Objective: To study the effect of post-operative Non-Steroidal Anti-inflammatory (NSAID) eye drops on macular thickness in patients without diabetic retinopathy measured by Optical Coherence Tomography (OCT).Study Design: Quasi-experimental study.Place & Duration of the Study: Ophthalmology Department/ Lahore General Hospital, Lahore from 15-01-2019 to 31-12-2021.Materials and Methods: Diabetic patients without retinopathy who required cataract surgery for visual rehabilitation were included in the study. They were then divided into two groups. Group A included patients who received routine steroid+antibiotic post-operative drops while Group B comprised of patients who received nepafenac (0.1%) eye drops eight hourly in addition to routine post-operative eye drops. All patients underwent standard phacoemulsification and intraocular lens implantation followed by the use of NSAID eye drops for a month. OCT measurements were done pre-operatively, 7 and 28 days post-operatively.Results:...
Review question / Objective: P – diabetic and non-diabetic patients undergoing phacoemulsification without macular edema; I – Nepafenac 0.1% or Nepafenac 0.3% in addition to topical steroids; C – topical steroids alone; O – Mean Differences of Foveal thickness (FT), total macular volume (TMV), best corrected visual acuity (BCVA), and intraocular pressure (IOP); S – Randomized controlled trials (RCTs). Condition being studied: Macular swelling or macular edema after cataract surgery when uncontrolled may compromise the blood-ocular barrier and allow inflammatory cells and cytokines to enter the aqueous humor, resulting in discomfort for the patient, a slower rate of recovery, subpar visual results, and even more complications like the development of synechiae, increased IOP, macular edema (ME), corneal edema, and so forth.
Journal of Evolution of Medical and Dental Sciences, 2020
BACKGROUND Pseudophakic cystoid macular oedema is a significant cause of suboptimal visual acuity post phacoemulsification. Diabetics are at greater risk of developing PCME following cataract surgery. Topical nepafenac ophthalmic suspension 0.1% is used to prevent inflammation postoperatively. We wanted to study the effect of Topical Nepafenac 0.1% eye suspension on macular thickness following phacoemulsification in patients of diabetes mellitus and correlate the final visual acuity and macular thickness. METHODS This prospective interventional study was conducted between January 2018 and May 2019 in the Department of Ophthalmology, MMIMSR, Mullana, Ambala. 100 patients based on the inclusion and exclusion criteria were included in the study and phacoemulsification was done. They were divided in to two groups of 50 each. Group 1 received topical Nepafenac 0.1% ophthalmic suspension thrice daily along with the routine post-op medications whereas Group 2 received routine post-op medications. The groups were analysed preoperatively and at 2, 4, 6, 8 weeks postoperatively and their CMT was recorded using a SD-OCT. The change in BCVA was analysed with the help of ETDRS letter chart. The data was entered in Microsoft Excel and analysed using SPSS-PC-20 version. Quantitative data was expressed by mean and standard deviation while qualitative data was expressed as percentage. Difference between the proportions was tested with Chi Square Test or Fisher's Exact test while difference between quantitative variable between the two groups was tested with students 't' test or Mann Whitney U test. For comparison of quantitative data between more than two groups, ANOVA or Kruskal Wallis 'H' test followed by post hoc test was used. A 'p' value of less than 0.05 was considered statistically significant. RESULTS A lower percentage of patients in Group 1 developed ME relative to Group 2 (2% vs. 8%; p-value= 0.36). The mean CMT was significantly lower in Group 1 at 2 (p-value<0.01), 4 (p-value<0.001), 6 (p-value<0.001) and 8 weeks (p-value<0.001). A greater percentage of patients in Group 1 (60%) experienced a gain of >15 letters as compared to the baseline (p-value<0.01). CONCLUSIONS Topical nepafenac helps in preventing macular oedema and improves the mean gain in letters read at 8 weeks of follow up.
International Journal of Contemporary Medical Research [IJCMR]
Introduction: Cataract is the most common surgical procedure. Study was done to compare the effect of nepafenac 0.1% plus prednisolone 1% vs prednisolone 1% alone in controlling ocular inflammation after phacoemulsification Material and Methods: A total of 140 patients were randomized to receive prednisolone 1% (group I) vs nepafenac plus prednisolone 1% (group II) after uneventful phacoemulsification. Patients were examined on first day, one week and one month for vision, slit lamp evaluation for anterior segment inflammation and cystoid macular edema. Results: Average visual acuity was 6/9 in both groups. Anterior segment inflammation was significantly less in group II on first post operative day. On later visits, there was no significant difference in inflammation in both groups. CME was not seen in any group. Conclusion: This study suggests that addition of nepafenac 0.1% to prednisolone 1% significantly reduces the intraocular inflammation after phacoemulsification in the early postoperative period.
2015
Background: To evaluate the effect of prophylactic nepafenac eye drops on macular thickness changes after phacoemulsification surgery in mild to moderate NPDR patients. Method: This study is an open label randomized clinical trial. Thirty-six subjects who met the inclusion criteria underwent phacoemulsification. One group (18 subjects) were given nepafenac 0.1% eye drops and the rest were given placebo. Foveal thickness was measured by SD-OCT before surgery and the fourth week after phacoemulsification. Best corrected visual acuity (BCVA) and degree of inflammation in the anterior chamber were also being assessed. Result: There was a statistically significant increase foveal thickness in the placebo group 4 weeks after phacoemulsification (p=0.022). Clinically, percentage degree of inflammation in anterior chamber in placebo group was higher than nepafenac group (38.9% : 5.6%) but not significantly different between 2 groups (p=0.27). Nepafenac group achieved clinically better BCVA ...
The British journal of ophthalmology, 2014
To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4% and nepafenac 0.1% eye drops for prophylaxis of cystoid macular oedema (CME) after small-incision cataract extraction. Patients were assigned randomly to three groups. Group 1 patients received a topical artificial tear substitute (placebo); group 2 received ketorolac tromethamine 0.4% (Acular LS, Allergan) and group 3 received nepafenac 0.1% (Nevanac, Alcon). The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography (OCT) after 1, 4 and 12 weeks. One hundred and twenty-six eyes of 126 patients were included in this study. The between-group differences in visual outcomes, central corneal thickness and endothelial cell density were not statistically significant. In all retinal thickness measurements, an increase was detected starting from the postoperative first week until 12 weeks. There was no statistically significant difference between the three groups in...
THE PROFESSIONAL MEDICAL JOURNAL
To determine the efficacy of topical nepafenac 0.1% eye drops as compared toprednisolone acetate 1% eye drops in the management of postoperative inflammation after cataract surgery. Study Design: Randomized controlled clinical study. Place and Duration of study: Pakistan air force hospital Rafiqui from Oct 2016 to Feb 2017. Patients and methods: Two hundred and forty eight eyes were randomly divided in two equal groups. Patients received nepafenac 0.1% or prednisolone acetate 1% as single drop 8 hourly beginning 1 day preoperatively, continued till 2 weeks post-operatively. Efficacy of the drug will be considered if there is no anterior chamber reaction along with no aqueous flare after 2 weeks of treatment. Results: 85.5% of cases resolved with topical nepafenac 0.1%as compared to 88.7% that were cured with prednisolone acetate 1%. Pearson chi square test indicates that there is no statistical significant difference (p= 0.449) between the efficacy of two modes of treatment. Conclusion: Nepafenac 0.1% eye drops are as effective as prednisolone acetate 1% in the prevention of postoperative inflammation with cataract surgery.
Topical Nepafenec in Eyes with Noncentral Diabetic Macular Edema
Retina, 2015
Purpose-To evaluate the effect of a topical non-steroidal anti-inflammatory drug, nepafenac 0.1%, in eyes with non-central diabetic macular edema (DME). Methods-Multi-center double-masked randomized trial. Individuals with good visual acuity and non-center involved DME were randomly assigned to nepafenac 0.1% (N = 61) or placebo (nepafenac vehicle, N = 64) three times a day for 12 months. The primary outcome was mean change in OCT retinal volume at 12 months. Results-Mean baseline retinal volume was 7.8 mm 3. At 12 months, in the nepafenac and placebo groups respectively, mean change in retinal volume was-0.03 mm 3 and-0.02 mm 3 (treatment group difference:-0.02, 95% CI:-0.27 to 0.23, P = 0.89). Central involved DME was present in 7 eyes (11%) and 9 eyes (14%) at the 12-month visit (P = 0.79), respectively. No differences in visual acuity outcomes were identified. One study participant developed a corneal
ABSTRACT… Objectives: To determine the efficacy of topical nepafenac 0.1% eye drops as compared toprednisolone acetate 1% eye drops in the management of postoperative inflammation after cataract surgery. Study Design: Randomized controlled clinical study. Place and Duration of study: Pakistan air force hospital Rafiqui from Oct 2016 to Feb 2017. Patients and methods: Two hundred and forty eight eyes were randomly divided in two equal groups. Patients received nepafenac 0.1% or prednisolone acetate 1% as single drop 8 hourly beginning 1 day preoperatively, continued till 2 weeks post-operatively. Efficacy of the drug will be considered if there is no anterior chamber reaction along with no aqueous flare after 2 weeks of treatment. Results: 85.5% of cases resolved with topical nepafenac 0.1%as compared to 88.7% that were cured with prednisolone acetate 1%. Pearson chi square test indicates that there is no statistical significant difference (p= 0.449) between the efficacy of two modes of treatment. Conclusion: Nepafenac 0.1% eye drops are as effective as prednisolone acetate 1% in the prevention of postoperative inflammation with cataract surgery.