Incidence of visually significant pseudophakic macular edema after uneventful phacoemulsification in patients treated with nepafenac.
OBJECTIVE
To compare the incidence of visually significant pseudophakic macular edema after uneventful phacoemulsification in patients treated postoperatively with topical prednisolone and those treated with topical prednisolone and nepafenac 0.1% suspension (Nevanac).


METHODS
Edward S. Harkness Eye Institute of Columbia University, New York, New York, USA.


METHODS
This retrospective chart review was of consecutive patients who had phacoemulsification at a single institute and were given topical prednisolone alone or topical prednisolone and nepafenac to prevent cystoid macular edema. Data collection included preexisting ocular and systemic diseases, concurrent use of ocular and systemic medications, surgical technique, intraoperative and postoperative complications, follow-up visual and ocular assessments, and postoperative optical coherence tomography (OCT) assessment for macular edema.


RESULTS
Postoperatively, 240 patients were treated with prednisolone and 210 patients, with prednisolone-nepafenac. Preoperatively, the 2 groups were demographically and clinically comparable in sex distribution (P = .8400), history of diabetes (P = .7267), hypertension or cardiac disease (P = .8690), and concurrent use of oral nonsteroidal anti-inflammatory drugs (P = .7303). Iris manipulation was done in 16 patients in the prednisolone-alone group and 10 patients in the prednisolone-nepafenac group (P = .3876). Capsule staining was done in 5 patients and 4 patients, respectively. All patients were followed for at least 1 month postoperatively. Visually significant pseudophakic macular edema was documented by OCT in 5 patients treated with prednisolone alone and in no patients treated with prednisolone and nepafenac (P = .0354). No significant intraoperative or postoperative complications were reported.


CONCLUSIONS
Patients treated with topical prednisolone alone had a significantly higher incidence of visually significant pseudophakic macular edema after uneventful cataract surgery than those treated with topical prednisolone and nepafenac.
Wolf
Eric J
EJ
Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, Department of Ophthalmology, 635 West 165th Street, New York, New York 10032, USA. ericwolfmd@yahoo.com
Braunstein
Alexandra
A
Shih
Carolyn
C
Braunstein
Richard E
RE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D044482:Benzeneacetamides / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008269:Macular Edema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D010648:Phenylacetates / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011239:Prednisolone / Q000627:therapeutic use; D019591:Pseudophakia / Q000209:etiology*; D012189:Retrospective Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D005938:Glucocorticoids; D010648:Phenylacetates; C414203:nepafenac; D011239:Prednisolone