Efficacy of addition of nepafenac 0.1% to steroid eye drops in prevention of post-phaco macular edema in high-risk eyes

Gharbawy, Shahenda A El; Darwish, Essam; Eleinen, Khaled G Abu; Osman, Moataz Hamed

doi:10.1177/1120672118799626

Cited by 10 publications

(6 citation statements)

References 37 publications

(62 reference statements)

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“…They concluded that a three-month use of nepafenac after cataract surgery helps prevent the development of macular edema without any safety concerns. El Gharbway 18 and colleagues studied the effect of nepafenac 0.1% eye drops after cataract surgery in patients (Glaucoma, uveitis, traumatic cataract) who were at high risk of developing post-operative pseudophakic macular edema. The study suggests the use of topical nepafenac eye drops after cataract surgery in high-risk patients as it significantly reduces the incidence of macular edema in pseudophakic patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of Topical Nepafenac on Macular Thickness after Phacoemulsification with Intraocular Lens Implantation in Patients without Diabetic Retinopathy

Amjad¹

2023

JRMC

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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: Comparison of central macular thickness between groups was significant at (Pre & 7-day post-op) and insignificant at (7th day & 28th day post-op) and (Pre & 28th day post-op) i.e. 0.043, 0.834, and 0.084 respectively. However, a difference in mean central macular thickness was significant at all follow-up periods i.e.0.003, 0.006, and 0.000.Conclusion: Post-operative NSAID in diabetic patients without retinopathy leads to a significant decrease in macular thickness as compared to controls after cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Impact of Topical Nepafenac on Macular Thickness after Phacoemulsification with Intraocular Lens Implantation in Patients without Diabetic Retinopathy

Amjad¹

2023

JRMC

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“…[ 56 ] A study reported that topical nepafenac 0.1% combined with topical steroids significantly reduced the incidence of uveitic CME after cataract extraction. [ 57 ] Schallhorn et al . investigated the efficacy of topical difluprednate in uveitic CME and reported improvement or resolution of uveitic CME in most eyes.…”

Section: P Ostoperative C Omplications A...mentioning

confidence: 99%

New insights into cataract surgery in patients with uveitis

Al-Essa

Alfawaz

2022

Saudi Journal of Ophthalmology

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Cataract is a common cause of visual impairment in uveitic eyes. The management of cataract in patients with uveitis is often challenging due to pre-existing ocular comorbidities that may limit the visual outcomes. A meticulous preoperative ophthalmic evaluation is needed to assess the concomitant ocular pathologies with special emphasis on the status of the macula and optic nerve. Preoperative control of inflammation for at least 3 months before surgery is a key prognostic factor for successful surgical outcomes. Perioperative use of systemic and topical corticosteroids along with other immunosuppressive medications is crucial to decrease the risk of postoperative inflammation and cystoid macular edema (CME). Phacoemulsification with intraocular lens implantation is the surgical option of choice for most patients with uveitic cataract. Uveitic cataracts are typically complicated by the presence of posterior synechiae and poor pupil dilation, necessitating manual stretching maneuvers or pupil expansion devices to dilate the pupil intraoperatively. Patients must be closely monitored for postoperative complications such as excessive postoperative inflammation, CME, raised intraocular pressure, hypotony, and other complications. Good outcomes can be achieved in uveitic eyes after cataract extraction with appropriate handling of perioperative inflammation.

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“…Therapeutic tools available for prophylaxis and treatment of PCME are based on the understanding of these factors and their pathways. The best prophylactic regimen for PCME has not been established, but corticosteroids and topical nonsteroidal anti-inflammatory drugs (NSAIDs), alone or combined have proven to be useful [20][21][22][23] and are extensively used as the first-line drugs 24 . A previous comprehensive study to evaluate PCME prevention after cataract surgery demonstrated that topical therapy with NSAIDs (bromfenac 0.09%) or steroids (dexamethasone 0.1%) alone, was related to a higher incidence of clinically significant PCME 12 weeks postoperatively (incidence of 3.6% and 5.1%, respectively) compared to combined therapy (incidence of 1.5%) 25 .…”

Section: Introductionmentioning

confidence: 99%

Novel triamcinolone acetonide-loaded liposomes topical formulation to prevent cystoid macular edema after femtosecond laser-assisted cataract surgery

Navarro-Partida¹,

Jauregui-García²,

Altamirano-Vallejo³

et al. 2020

RMOE

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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.

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Efficacy of addition of nepafenac 0.1% to steroid eye drops in prevention of post-phaco macular edema in high-risk eyes

Abstract: Addition of topical nepafenac eye drops to topical steroid drops significantly reduced the amount of pseudophakic macular edema after cataract surgery in high-risk eyes.

Cited by 10 publications

References 37 publications

Impact of Topical Nepafenac on Macular Thickness after Phacoemulsification with Intraocular Lens Implantation in Patients without Diabetic Retinopathy

Impact of Topical Nepafenac on Macular Thickness after Phacoemulsification with Intraocular Lens Implantation in Patients without Diabetic Retinopathy

New insights into cataract surgery in patients with uveitis

Novel triamcinolone acetonide-loaded liposomes topical formulation to prevent cystoid macular edema after femtosecond laser-assisted cataract surgery

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