title: Single perioperative subconjunctival steroid depot versus postoperative steroid eyedrops to prevent intraocular inflammation and macular edema after cataract surgery.
abstract: OBJECTIVE
  To compare the efficacy of dexamethasone 0.1% eyedrops after phacoemulsification versus a single perioperative subconjunctival injection of betamethasone acetate 5.7 mg/mL to prevent anterior segment inflammation and macular edema.
  
  
  METHODS
  Rotterdam Eye Hospital, Rotterdam, The Netherlands.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Patients scheduled for cataract surgery were randomly assigned to receive a perioperative subconjunctival injection of betamethasone acetate 5.7 mg/mL (Group 1) or postoperative administration of dexamethasone 0.1% eyedrops (Group 2). Primary outcomes were foveal thickness and macular edema on optical coherence tomography (OCT) and anterior chamber flare by a laser flare meter preoperatively and 4 weeks postoperatively. Secondary outcomes were intraocular pressure, need for additional outpatient clinic visits, phacoemulsification energy, verbal-rating pain scale, and corrected distance visual acuity.
  
  
  RESULTS
  The study enrolled 400 patients (400 eyes). Four weeks postoperatively, the mean flare values were significantly higher in Group 1 than in Group 2 (P=.003). The incidence of macular edema on OCT and clinically significant macular edema were not significantly different between groups (P=.685 and P=.386, respectively). No significant difference was observed in any other outcome measure.
  
  
  CONCLUSIONS
  A single subconjunctival betamethasone acetate injection appears to be a useful alternative to prolonged postoperative administration of dexamethasone eyedrops in controlling intraocular inflammation and development of macular edema after phacoemulsification.
authors.affiliation: Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands. m.dieleman@eyehospital.nl
authors.forename: Myrthe
authors.initials: M
authors.lastname: Dieleman
authors.forename: René J
authors.initials: RJ
authors.lastname: Wubbels
authors.forename: Marina
authors.initials: M
authors.lastname: van Kooten-Noordzij
authors.forename: Peter W T
authors.initials: PW
authors.lastname: de Waard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001623:Betamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D056965:Injections, Intraocular; D007429:Intraocular Pressure / Q000502:physiology; D008269:Macular Edema / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D018918:Phacoemulsification; D010783:Photometry; D011183:Postoperative Complications / Q000517:prevention & control*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000517:prevention & control*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D003907:Dexamethasone; D001623:Betamethasone