Purpose: To assess visual results, macular modifications, and the incidence of clinically significant macular edema (CSME) in patients using a topical triamcinolone acetonide-loaded liposomal formulation (TA-LF) after femtosecond laser-assisted cataract surgery (FLACS). Methods: Fifty-six eyes after FLACS were selected. Twenty-eight eyes in the combined therapy group (P + N) were treated with prednisolone 1% and nepafenac 0.1% for 21 days postoperatively, whereas 28 eyes in the TA-LF group received a liposomal formulation containing 2 mg/mL of TA (0.2%) for the same period of time. Follow-up visits at 1 day, 6 weeks, and 12 weeks after surgery consisted of visual acuity, contrast sensitivity (CS), central foveal thickness (CFT), total macular volume (TMV) measurements, and the detection of CSME. Results: CS improved in the TA-LF group (basal value: 1.087-0.339 vs. 1.276-0.147 at week 12, P = 0.0346), whereas in the P + N group, CS was not different from the baseline (basal value: 1.130-0.331 vs. 1.274-0.133 at week 12, P = 0.1276). There were similar increases in postoperative CFT and TMV in both groups. CFT and TMV significantly correlate with CS only in the TA-LF group. The r 2 for CFT and CS was 0.1963 (P = 0.0206), whereas the r 2 for TMV and CS was 0.3615 (P = 0.0007) at 12 weeks. No difference was observed in the incidence of CSME between the groups. Conclusion: TA-LF is associated with better CS outcomes compared to combined therapy after FLACS.
The aim of this study is to report the tolerability, safety and efficacy of a topical triamcinolone acetonide-loaded liposomes formulation (TA-LF) to prevent clinically significant macular edema (CSME) after femtosecond laser-assisted cataract surgery (FLACS). Methods: Fifty-five eyes of 32 patients who underwent FLACS were enrolled. Twenty-seven eyes were assigned to the TA group whereas twenty-eight eyes were assigned to the TA-LF group. In the TA group, eyes were exposed to a conventional topical formulation of triamcinolone acetonide 0.1% for 21 days postoperatively, whereas patients in the TA-LF group received a liposomal formulation containing 2 mg/ml of TA (0.2%). A follow-up consisting on slit-lamp examination, visual acuity, contrast sensitivity, central foveal thickness (CFT) and total macular volume (TMV) (both measured by retinal optical coherence tomography) was performed. Study visits were scheduled at 1 day, 6, and 12 weeks after surgery. results: The incidence of CSME in the TA group at 6 weeks was 22.2%, in contrast, the incidence of these finding in the TA-LF group was 0%. A conventional steroid formulation (TA 0.1%) was associated with an increased risk of CSME (OR, 9.44; 95% CI, P= 0.027). Finally, no ocular or systemic adverse events were reported in any group. conclusion: TAloaded liposomal formulation is effective for the prevention of CSME associated with FLACS, and it seems that its therapeutic activity could be superior to the activity of a conventional topical steroid formulation.
tópico cargados con acetónido de triamcinolona (FL-AT), útil en la prevención del edema macular clínicamente significativo (EMCS) que ocurre después de la cirugía de catarata asistida con láser de femtosegundo (FLACS). Métodos: Se estudiaron 55 ojos de 32 pacientes a los que se realizó FLACS. Se asignaron 27 ojos al grupo de acetónido de triamcinolona (AT), mientras que 28 ojos fueron asignados al grupo de FL-AT. En el grupo de AT, los ojos se expusieron a una formulación tópica convencional de AT al 0.1% durante 21 días tras la cirugía, mientras que los pacientes en el grupo FL-AT recibieron una formulación liposomal que contenía 2 mg/ml de AT (0.2%). Se realizó un seguimiento clínico que comprendió: examen con lámpara de hendidura, agudeza visual, sensibilidad al contraste, grosor foveal central y volumen macular total. Las visitas del estudio se programaron los días 1 y 6 y al final de la semana 12 del periodo postoperatorio. resultados: La incidencia de EMCS en el grupo de AT a las 6 semanas fue del 22.2%, en contraste con el grupo de FL-AT, en el cual fue de 0%. La formulación de esteroides convencionales (AT al 0.1%) se asoció con un mayor riesgo de EMCS (OR: 9.44; IC del 95%: 1.76-50.66; p = 0.027). Finalmente, no se reportaron eventos adversos oculares ni sistémicos en ningún grupo. conclusión: La FL-AT es eficaz para la prevención del EMCS asociado con FLACS, y parece que su actividad terapéutica es superior a la actividad de la formulación de esteroides tópicos convencionales.Palabras clave: Liposomas. Acetónido de triamcinolona. Edema macular. Cirugía de catarata asistida con láser de femtosegundo.
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