Preoperative topical indomethacin to prevent pseudophakic cystoid macular edema.
OBJECTIVE
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.


METHODS
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 chi-square 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 = .83). Postoperative visual acuity was significantly higher in the group receiving preoperative indomethacin (P<.001).


CONCLUSIONS
Nonsteroidal antiinflammatory drugs decreased the incidence of CME, and their efficacy increased when begun preoperatively.
Yavas
Güliz Fatma
GF
Afyon Kocatepe University, Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey. gkumbar@ttnet.net.tr
Oztürk
Faruk
F
Küsbeci
Tuncay
T
D000287:Administration, Topical; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage*; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011300:Preoperative Care / Q000379:methods; D019591:Pseudophakia / Q000150:complications*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin