Diclofenac prevents an early event of macular thickening after cataract surgery in patients with diabetes.
OBJECTIVE
This study compares the effect of topical diclofenac with that of betamethasone against postoperative cystoid macular edema (CME) following cataract surgery in patients with non- and mild nonproliferative diabetic retinopathy.


METHODS
Forty-six (46) consecutive patients with mild nonproliferative- or nondiabetic retinopathy who had bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (92 eyes in total). Postoperatively, topical diclofenac was applied 4 times daily for 1 eye, and topical betamethasone 4 times daily for the other eye in each patient. Best corrected logMAR visual acuity (BCVA), averaged foveal thickness (FT) as measured by optical coherence tomography (OCT), and intraocular pressure (IOP) were monitored preoperatively, and also postoperatively at 1 day and 1, 4, and 8 weeks.


RESULTS
VA in both the diclofenac- and betamethasone-treated eyes significantly improved following the cataract surgery; however, no statistical difference of VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observational period (before and after the surgery until 8 weeks postoperatively). FT in both eyes increased after the cataract surgery. FT in the diclofenac-treated eyes did not increase 1 week after surgery, but gradually increased at week 4 and week 8. In contrast, the FT in the betamethasone-treated eyes increased during 1-8 weeks postoperatively. IOP in the diclofenac-treated eyes decreased with time, but IOP in the betamethasone-treated eyes showed no change throughout the observational period.


CONCLUSIONS
Postoperative macular thickening following cataract surgery in patients with non- or mild nonproliferative-diabetic retinopathy cannot be fully suppressed by either topical diclofenac or betamethasone. Nonetheless, diclofenac protected against an early event of postoperative CME and also a decrease of IOP.
Shimura
Masahiko
M
Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan. masahiko@v101.vaio.ne.jp
Nakazawa
Toru
T
Yasuda
Kanako
K
Nishida
Kohji
K
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001623:Betamethasone / Q000627:therapeutic use*; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications; D004008:Diclofenac / Q000627:therapeutic use*; D005260:Female; D005584:Fovea Centralis / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008269:Macular Edema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011183:Postoperative Complications; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D004008:Diclofenac; D001623:Betamethasone