Articoli Scientifici di Oftalmologia
Argomento : 3
Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema
PURPOSE: To evaluate the effectiveness of a nonsteroidal antiinflammatory drug (NSAID) on pseudophakic
cystoid macular edema (CME) and determine the efficacy when used preoperatively and
after uneventful phacoemulsification surgery.
SETTING: Department of Ophthalmology, Kocatepe University, School of Medicine, Afyonkarahisar,
Turkey.
METHODS: One hundred seventy-nine eyes of 189 patients having uneventful phacoemulsification
surgery were enrolled in the study. After surgery, all patients used topical steroids and antibiotics 4
times daily. Sixty-one eyes, chosen randomly, received a topical NSAID (indomethacin) 4 times
daily for 3 days preoperatively and 1 month postoperatively. Sixty eyes received topical indomethacin
4 times daily for 1 month postoperatively. Fifty-eight eyes served as a control group and received
only topical steroids and antibiotics. At the third postoperative month, visual acuity,
fluorescein angiograms, and macular thresholds were evaluated. Statistical analysis was by chisquare
and 1-way analysis of variance tests.
RESULTS: Cystoid macular edema was not seen in the group receiving indomethacin preoperatively
and postoperatively. The incidence of angiographic CME was 15.0% in the group receiving postoperative
indomethacin and 32.8% in the control group (P<.001). Mean sensitivity in the macular
threshold test did not show a significant change between groups (P Z .83). Postoperative visual
acuity was significantly higher in the group receiving preoperative indomethacin (P<.001).
CONCLUSION: Nonsteroidal antiinflammatory drugs decreased the incidence of CME, and their efficacy
increased when begun preoperatively