Comparison of visual acuity and post-operative inflammation in phacoemulsification and removal of silicone oil with and without injection of Enoxaparin Sodium (40mg/0.04ml)

Abstract

Background: Phacoemulsification and removal of silicone oil (ROSO) is a combined, frequently done procedure in retina theatre. A common problem in this procedure is the post inflammation that affects the recovery of the patients. Thus to counter this post-operative inflammation, the study has used Enoxaparin Sodium (an anti-inflammatory enoxaparin) to counter the post-operative inflammation in phacoemulsification and ROSO. Patients and methods: Prospective interventional study done at Ophthalmology Department, Lahore General Hospital, included 60 patients which were operated and observed for results over a period of 3 months. Total 60 patients were randomly allocated in two groups, Group A and B. Both groups underwent phacoemulsification and ROSO. Group A had Enoxaparin Sodium, admixed in infusion bottles with a dosage of 40mg/0.04ml while Group B was operated without Enoxaparin Sodium. Patients were examined on slit lamp on the 1st day after the surgery then on the 7th day and every month for 3 months for post-operative inflammation and visual recovery. The effectiveness of the procedure was defined by the comparison of post-operative inflammation as well as speedy recovery of sight. Results: Total 60 patients were randomly allocated in two groups. Group A had 30 patients, 23 males and 7 females, with mean age of 49.43 years. Group B included 30 patients, 19 males and 11 females, with mean age of 47.73 years. Post-operative BCVA in Group A was above vision 6/60 (Snellen’s Chart) in 90% of cases while it improved to vision 6/36 and better in 93% of cases at 7th day while 93% of cases crossed recovery of Vision 6/18 by 3rd Month. While in Group B, Vision 6/60 was observed in 70% of cases while it improved to vision 6/36 and better in 67% of cases at 7th day while 53% of cases crossed recovery of vision 6/18 by 3rd Month. Post-operative results for inflammation of Group B showed grade 3 reaction on first day (94%) while it reduced to grade 2 reaction on 7th day in 97% of the cases. While Group A was observed with occasional activity in 25 out of 30 cases (84%) on the first day and grade 2 reaction in 5 (16%) cases. 100% cases of Group A showed occasional activity on 7th day with better visual recovery. Conclusion: Intraoperative use of Enoxaparin Sodium helped in reducing post-operative inflammation as well as aided in better visual acuity after phacoemulsification and ROSO thus proving to be a viable enoxaparin agent to reduce post-operative reactions in these surgeries.