Efficacy of topical dexamethasone eye drops in preventing ocular inflammation and cystoid macular edema following uncomplicated cataract surgery with or without injection of a single dose perioperative subtenon triamcinolone acetonide.
Buğra Karasu, Enes Kesim, Mert Kaskal, Ali Rıza Cenk Celebi
{"title":"Efficacy of topical dexamethasone eye drops in preventing ocular inflammation and cystoid macular edema following uncomplicated cataract surgery with or without injection of a single dose perioperative subtenon triamcinolone acetonide.","authors":"Buğra Karasu, Enes Kesim, Mert Kaskal, Ali Rıza Cenk Celebi","doi":"10.1080/15569527.2022.2136193","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of topical dexamethasone (DEX) eye drops in combination with a single perioperative subtenon triamcinolone acetonide (sTA) injection versus conventional topical DEX eye drops in the prevention of ocular inflammation and cystoid macular edema following cataract surgery.</p><p><strong>Materials and methods: </strong>Medical records of 245 eyes of 245 patients who underwent uncomplicated cataract surgery were analyzed in this retrospective controlled clinical study. Topical DEX eye drops were administered to 128 eyes routinely postoperatively, and 117 eyes were given a single dose of sTA (40 mg/ml) together with topical DEX eye drops for postoperative care. Postoperative topical antibiotic prophylaxis was applied to all eyes. The primary outcomes were anterior chamber (AC) cells and flare, central macular thickness (CMT), best corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements on day 7, day 30, day 90, and day 180 following surgery.</p><p><strong>Results: </strong>Although CMT increased in the DEX group, no increment was observed in the DEX + sTA treated group for all follow-up periods (on day 7 (+1.3 ± 18.6 and -8.7 ± 21.9 μm, <i>p</i> = 0.038), on day 30 (+20.5 ± 58.4 and -4.1 ± 25.2 μm, <i>p</i> = 0.009), on day 90 (+7.2 ± 19.9 and -5.7 ± 30.6 μm, <i>p</i> = 0.029), and on day 180 (+8.2 ± 22.6 and -6.4 ± 32.9 μm, <i>p</i> = 0.032)). There was no significant difference in terms of AC cells and flare between the two groups during the entire follow-up period (<i>p</i> > 0.05). Significant improvement in BCVA was observed in the DEX + sTA group at day 30 (<i>p</i> = 0.008). IOP differences were comparable, and both groups had high ocular tolerance. There were no severe adverse effects recorded.</p><p><strong>Conclusions: </strong>Topical DEX eye drops in combination with single dose perioperative injection of sTA have robust efficacy in preventing ocular inflammation and the development of cystoid macular edema following uncomplicated cataract surgery.</p>","PeriodicalId":11023,"journal":{"name":"Cutaneous and Ocular Toxicology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cutaneous and Ocular Toxicology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/15569527.2022.2136193","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/10/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 3
Abstract
Purpose: To evaluate the efficacy and safety of topical dexamethasone (DEX) eye drops in combination with a single perioperative subtenon triamcinolone acetonide (sTA) injection versus conventional topical DEX eye drops in the prevention of ocular inflammation and cystoid macular edema following cataract surgery.
Materials and methods: Medical records of 245 eyes of 245 patients who underwent uncomplicated cataract surgery were analyzed in this retrospective controlled clinical study. Topical DEX eye drops were administered to 128 eyes routinely postoperatively, and 117 eyes were given a single dose of sTA (40 mg/ml) together with topical DEX eye drops for postoperative care. Postoperative topical antibiotic prophylaxis was applied to all eyes. The primary outcomes were anterior chamber (AC) cells and flare, central macular thickness (CMT), best corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements on day 7, day 30, day 90, and day 180 following surgery.
Results: Although CMT increased in the DEX group, no increment was observed in the DEX + sTA treated group for all follow-up periods (on day 7 (+1.3 ± 18.6 and -8.7 ± 21.9 μm, p = 0.038), on day 30 (+20.5 ± 58.4 and -4.1 ± 25.2 μm, p = 0.009), on day 90 (+7.2 ± 19.9 and -5.7 ± 30.6 μm, p = 0.029), and on day 180 (+8.2 ± 22.6 and -6.4 ± 32.9 μm, p = 0.032)). There was no significant difference in terms of AC cells and flare between the two groups during the entire follow-up period (p > 0.05). Significant improvement in BCVA was observed in the DEX + sTA group at day 30 (p = 0.008). IOP differences were comparable, and both groups had high ocular tolerance. There were no severe adverse effects recorded.
Conclusions: Topical DEX eye drops in combination with single dose perioperative injection of sTA have robust efficacy in preventing ocular inflammation and the development of cystoid macular edema following uncomplicated cataract surgery.
期刊介绍:
Cutaneous and Ocular Toxicology is an international, peer-reviewed journal that covers all types of harm to cutaneous and ocular systems. Areas of particular interest include pharmaceutical and medical products; consumer, personal care, and household products; and issues in environmental and occupational exposures.
In addition to original research papers, reviews and short communications are invited, as well as concise, relevant, and critical reviews of topics of contemporary significance.