AIM:To evaluate the effect of topical preoperative nepafenac 0.1%treatment on postoperative macular edema using optical coherence tomography(OCT)after uncomplicated cataract surgery.METHODS:Ninety eyes of 90 patients ...AIM:To evaluate the effect of topical preoperative nepafenac 0.1%treatment on postoperative macular edema using optical coherence tomography(OCT)after uncomplicated cataract surgery.METHODS:Ninety eyes of 90 patients without any risk factors were included in the study.The patients were assigned to three groups:group 1,treated with topical prednisolone acetate 1%;group 2,treated with topical nepafenac 0.1%in addition to prednisolone acetate(1%);and group 3,those who started receiving nepafenac 0.1%treatment 3 d prior to surgery and continued the treatment postoperatively in addition to prednisolone acetate(1%).Central retinal thickness(CRT)and macular volume values were recorded using OCT at weeks 3 and 6.RESULTS:The increases in macular volume in the central 1 mm area after 3 and 6 wk were significantly lower in patients who used prophylactic topical nepafenac preoperatively(group 3)compared with those in group 1(P=0.028 and 0.008,respectively).No significant differences in the increase in macular volume and CRT were noted between groups 2 and 3(P>0.05).In group 1,the increases in macular volume in the central 3 mm area at weeks 3 and 6 were significantly higher than that in group 2 and 3(3rd week,P=0.004;6th week,P=0.005).CONCLUSION:Nepafenac 0.1%treatment in addition to topical steroids after uncomplicated cataract surgery reduce the increase in macular volume in the early postoperative period.展开更多
AIM:To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography(OCT)and to estimate the incidence of development or worsening of macular edema(ME)in dia...AIM:To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography(OCT)and to estimate the incidence of development or worsening of macular edema(ME)in diabetic eyes with or without pre-existing ME.·METHODS:In this prospective,observational study,92eyes of 60 diabetic patients who underwent cataract surgery were evaluated before surgery and 1,3mo after surgery using OCT.Macular thickness was measured with OCT at nine macular subfields defined by the 9zones early treatment of diabetic retinopathy study(ETDRS),as well as total macular volume obtained by OCT at 1,3mo after surgery were compared with baseline features obtained before surgery.In addition,the incidence of development or worsening of ME was analyzed in diabetic eyes with or without pre-existing ME.·R ESULTS:The central subfield mean thickness increased 21.0μm and 25.5μm at 1,3mo follow-up,respectively(〈0.01).The average thickness of inner ring and outer ring increased 14.2μm and 9.5μm at 1mo,18.2μm and 12.9μm at 3mo.Central-involved ME developed in 12 eyes at 3mo,including 4 eyes with preexisting central-involved and 8 eyes with pre-existing non-central involved ME.Pre-existing diabetic macular edema(DME)was significantly associated with centralinvolved ME development(〈0.001).·C ONCLUSION:A statistically significant increase could be detected in the central subfield as well as perifoveal and parafoveal sectors though the increase was mild.And eyes with pre-operative DME prior to cataract surgery are at higher risk for developing central-involved ME.展开更多
AIM: To investigate the effectiveness of combinationtherapy with transzonular triamcinolone-moxifloxacin andconventional perioperative drops in reducing postoperativecomplications of cataract surgery. METHODS: Electro...AIM: To investigate the effectiveness of combinationtherapy with transzonular triamcinolone-moxifloxacin andconventional perioperative drops in reducing postoperativecomplications of cataract surgery. METHODS: Electronic medical records of cataractsurgery patients (single surgeon) were reviewed fromJanuary 2018 to September 2021. The rate of postoperativecomplications including prolonged and/or recurrentpostoperative inflammation, endophthalmitis, cystoid macularedema (CME), and intraocular pressure (IOP) was comparedbetween the patients receiving combinative therapy andpatients receiving drops only. RESULTS: Totally 596 patients and 1057 eyes(Combinative-Therapy group 493 and Drop-Only group 564)were included in this study. Using combination therapyreduced the relative risk of postoperative inflammationby 26.9% (16.6% Combinative-Therapy vs 22.7% Drop-Only, P=0.013). The incidence of endophthalmitis was 0in Combinative-Therapy group vs 0.5% in Drop-Only group(relative risk reduction 100%), although not statisticallysignificant (P=0.10). The incidence of severe IOP spikeswas not significantly different between Combinative-Therapy (2.4%) and Drop-Only (1.6%) groups (P=0.33).The relative risk of postoperative CME was 51.4% less inthree months follow up visit in Combinative-Therapy group,although not statistically significant (P=0.07). The visualoutcome 1-month postop. (best corrected visual acuity) wassignificantly better in Combinative-Therapy (logMAR 0.10)compared to Drop-Only (logMAR 0.14) groups (P=0.02) whilethe baseline visual acuity was not significantly different. CONCLUSION: The combinative approach oftranszonular triamcinolone-moxifloxacin plus perioperativeeyedrops is an effective method to minimize postoperativeinflammation, with better visual outcomes. It couldpotentially reduce the risk of postoperative endophthalmitisand CME (near-significant P-values;larger studies couldanalyze better considering low incidence).展开更多
AIM: To evaluate the effect of prophylactic administration of nepafenac in prevention of macular edema occurring in diabetic patients after phacoemulsification and to investigate the correlation between optical cohere...AIM: To evaluate the effect of prophylactic administration of nepafenac in prevention of macular edema occurring in diabetic patients after phacoemulsification and to investigate the correlation between optical coherence tomography(OCT) foveal thickness and multifocal electroretinogram(MF-ERG) parameters.METHODS: The study included two groups. Group 1 included 50 diabetic patients with senile cataract(50 eyes, 30 females, 20 males, aged 55±7 y) received nepafenac 0.1% eye drop. Group 2 included another 50 diabetic patients with senile cataract(50 eyes, 22 female, 28 males, aged 53.8±8 y) did not receive nepafenac. All patients were followed up for 3 mo postoperatively. OCT and MF-ERG were done preoperative and at 1 wk, 1, 2 and 3 mo.RESULTS: The mean foveal thickness was statistically significantly lower in Group 1. Five eyes in Group 2 developed clinical cystoid macular oedema(CMO)(10%), and no patients in Group 1 developed central macular thickening more than 50 μm. There were insignificant differences in MF-ERG amplitudes and latencies between the two groups except in the five eyes that developed CMO, there statistically significant reduction of MF-ERG amplitude with increase in foveal thickness. CONCLUSION: Perioperative nepafenac reduces the incidence of CMO following uncomplicated phacoemulsification significantly. Nepafenac has no side effects.展开更多
Phacoemulsification with intraocular lens (IOL) implantation has become the most widely acceptedand effective surgery for cataract patients. Although progress in this technique has greatly reduced surgery-related co...Phacoemulsification with intraocular lens (IOL) implantation has become the most widely acceptedand effective surgery for cataract patients. Although progress in this technique has greatly reduced surgery-related complications, visual acuity can be substantially compromised in certain circumstances, postoperatively. Cystoid macular edema (CME) is one of the most common complications and needs special attention.展开更多
文摘AIM:To evaluate the effect of topical preoperative nepafenac 0.1%treatment on postoperative macular edema using optical coherence tomography(OCT)after uncomplicated cataract surgery.METHODS:Ninety eyes of 90 patients without any risk factors were included in the study.The patients were assigned to three groups:group 1,treated with topical prednisolone acetate 1%;group 2,treated with topical nepafenac 0.1%in addition to prednisolone acetate(1%);and group 3,those who started receiving nepafenac 0.1%treatment 3 d prior to surgery and continued the treatment postoperatively in addition to prednisolone acetate(1%).Central retinal thickness(CRT)and macular volume values were recorded using OCT at weeks 3 and 6.RESULTS:The increases in macular volume in the central 1 mm area after 3 and 6 wk were significantly lower in patients who used prophylactic topical nepafenac preoperatively(group 3)compared with those in group 1(P=0.028 and 0.008,respectively).No significant differences in the increase in macular volume and CRT were noted between groups 2 and 3(P>0.05).In group 1,the increases in macular volume in the central 3 mm area at weeks 3 and 6 were significantly higher than that in group 2 and 3(3rd week,P=0.004;6th week,P=0.005).CONCLUSION:Nepafenac 0.1%treatment in addition to topical steroids after uncomplicated cataract surgery reduce the increase in macular volume in the early postoperative period.
文摘AIM:To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography(OCT)and to estimate the incidence of development or worsening of macular edema(ME)in diabetic eyes with or without pre-existing ME.·METHODS:In this prospective,observational study,92eyes of 60 diabetic patients who underwent cataract surgery were evaluated before surgery and 1,3mo after surgery using OCT.Macular thickness was measured with OCT at nine macular subfields defined by the 9zones early treatment of diabetic retinopathy study(ETDRS),as well as total macular volume obtained by OCT at 1,3mo after surgery were compared with baseline features obtained before surgery.In addition,the incidence of development or worsening of ME was analyzed in diabetic eyes with or without pre-existing ME.·R ESULTS:The central subfield mean thickness increased 21.0μm and 25.5μm at 1,3mo follow-up,respectively(〈0.01).The average thickness of inner ring and outer ring increased 14.2μm and 9.5μm at 1mo,18.2μm and 12.9μm at 3mo.Central-involved ME developed in 12 eyes at 3mo,including 4 eyes with preexisting central-involved and 8 eyes with pre-existing non-central involved ME.Pre-existing diabetic macular edema(DME)was significantly associated with centralinvolved ME development(〈0.001).·C ONCLUSION:A statistically significant increase could be detected in the central subfield as well as perifoveal and parafoveal sectors though the increase was mild.And eyes with pre-operative DME prior to cataract surgery are at higher risk for developing central-involved ME.
文摘AIM: To investigate the effectiveness of combinationtherapy with transzonular triamcinolone-moxifloxacin andconventional perioperative drops in reducing postoperativecomplications of cataract surgery. METHODS: Electronic medical records of cataractsurgery patients (single surgeon) were reviewed fromJanuary 2018 to September 2021. The rate of postoperativecomplications including prolonged and/or recurrentpostoperative inflammation, endophthalmitis, cystoid macularedema (CME), and intraocular pressure (IOP) was comparedbetween the patients receiving combinative therapy andpatients receiving drops only. RESULTS: Totally 596 patients and 1057 eyes(Combinative-Therapy group 493 and Drop-Only group 564)were included in this study. Using combination therapyreduced the relative risk of postoperative inflammationby 26.9% (16.6% Combinative-Therapy vs 22.7% Drop-Only, P=0.013). The incidence of endophthalmitis was 0in Combinative-Therapy group vs 0.5% in Drop-Only group(relative risk reduction 100%), although not statisticallysignificant (P=0.10). The incidence of severe IOP spikeswas not significantly different between Combinative-Therapy (2.4%) and Drop-Only (1.6%) groups (P=0.33).The relative risk of postoperative CME was 51.4% less inthree months follow up visit in Combinative-Therapy group,although not statistically significant (P=0.07). The visualoutcome 1-month postop. (best corrected visual acuity) wassignificantly better in Combinative-Therapy (logMAR 0.10)compared to Drop-Only (logMAR 0.14) groups (P=0.02) whilethe baseline visual acuity was not significantly different. CONCLUSION: The combinative approach oftranszonular triamcinolone-moxifloxacin plus perioperativeeyedrops is an effective method to minimize postoperativeinflammation, with better visual outcomes. It couldpotentially reduce the risk of postoperative endophthalmitisand CME (near-significant P-values;larger studies couldanalyze better considering low incidence).
文摘AIM: To evaluate the effect of prophylactic administration of nepafenac in prevention of macular edema occurring in diabetic patients after phacoemulsification and to investigate the correlation between optical coherence tomography(OCT) foveal thickness and multifocal electroretinogram(MF-ERG) parameters.METHODS: The study included two groups. Group 1 included 50 diabetic patients with senile cataract(50 eyes, 30 females, 20 males, aged 55±7 y) received nepafenac 0.1% eye drop. Group 2 included another 50 diabetic patients with senile cataract(50 eyes, 22 female, 28 males, aged 53.8±8 y) did not receive nepafenac. All patients were followed up for 3 mo postoperatively. OCT and MF-ERG were done preoperative and at 1 wk, 1, 2 and 3 mo.RESULTS: The mean foveal thickness was statistically significantly lower in Group 1. Five eyes in Group 2 developed clinical cystoid macular oedema(CMO)(10%), and no patients in Group 1 developed central macular thickening more than 50 μm. There were insignificant differences in MF-ERG amplitudes and latencies between the two groups except in the five eyes that developed CMO, there statistically significant reduction of MF-ERG amplitude with increase in foveal thickness. CONCLUSION: Perioperative nepafenac reduces the incidence of CMO following uncomplicated phacoemulsification significantly. Nepafenac has no side effects.
文摘Phacoemulsification with intraocular lens (IOL) implantation has become the most widely acceptedand effective surgery for cataract patients. Although progress in this technique has greatly reduced surgery-related complications, visual acuity can be substantially compromised in certain circumstances, postoperatively. Cystoid macular edema (CME) is one of the most common complications and needs special attention.