Effect of topical prednisolone and diclofenac on the short-term change in morphology of posterior capsular opacification.
OBJECTIVE
To observe and document the effect of steroidal and nonsteroidal antiinflammatory treatment on the formation of Elschnig pearls.


METHODS
A prospective, randomized, double blinded, placebo controlled, two-way-cross-over study.


METHODS
Thirty-nine eyes of 32 patients with pronounced, regeneratory posterior capsule opacification (PCO) were included. The patients were treated topically with prednisolone and diclofenac (verum) or with lubricating eye drops (placebo) four times daily for one week. After a wash-out period of two weeks the patients received the contrary treatment also four times daily for one week. Digital retroillumination images were taken at day one, three, five, eight, and 15 of each medication period. The changes in the size of 4,675 Elschnig pearls were analyzed.


RESULTS
The mean cumulative area of all marked pearls/eye and follow-up was 1.2 mm(2) (range: 0.1 mm(2) to 3.2 mm(2)). The mean pearl size was 12,809 microm(2) (range: 60 microm(2) to 1.08 x 10(6) microm(2)). Between the follow-up examinations, 1,274 pearls disappeared (mean: 33 pearls/eye, range: five to 69 pearls; 27%) and 777 newly formed pearls appeared (mean: 20 pearls/eye, range: three to 53 pearls; 20%). There was no statistically significant difference in pearl size change and in number of disappeared and newly appeared pearls between the verum and the placebo treatments.


CONCLUSIONS
Topical prednisolone and diclofenac do not influence the short-term change of Elschnig pearls. Elschnig pearls disappear and appear within days. The degree of progression and regression varies greatly among eyes.
Neumayer
Thomas
T
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Buehl
Wolf
W
Findl
Oliver
O
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002386:Cataract / Q000473:pathology*; D002387:Cataract Extraction; D018592:Cross-Over Studies; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D019591:Pseudophakia / Q000209:etiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D004008:Diclofenac; D011239:Prednisolone