title: Nepafenac 0.1% versus fluorometholone 0.1% for preventing cystoid macular edema after cataract surgery.
abstract: OBJECTIVE
  To compare a topical nonsteroidal antiinflammatory drug (nepafenac 0.1%) and a topical steroidal antiinflammatory drug (fluorometholone 0.1% ) in preventing cystoid macular edema (CME) and blood-aqueous barrier (BAB) disruption after small-incision cataract extraction with foldable intraocular lens (IOL) implantation.
  
  
  METHODS
  Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan.
  
  
  METHODS
  Randomized double-masked single-center clinical trial.
  
  
  METHODS
  Patients were randomized to receive nepafenac 0.1% eyedrops or fluorometholone 0.1% eyedrops for 5 weeks after phacoemulsification with foldable IOL implantation. The incidence and severity of CME were evaluated by fluorescein angiography, retinal foveal thickness on optical coherence tomography, and BAB disruption on laser flare-cell photometry.
  
  
  RESULTS
  Thirty patients received nepafenac and 29 patients, fluorometholone. Five weeks postoperatively, the incidence of fluorescein angiographic CME was significantly lower in the nepafenac group (14.3%) than in the fluorometholone group (81.5%) (P<.0001). The fovea was thinner in the nepafenac group than in the fluorometholone group at 2 weeks (P=.0266) and 5 weeks (P=.0055). At 1, 2, and 5 weeks, anterior chamber flare was significantly less in the nepafenac group than in the fluorometholone group (P<.0001, P<.0001, and P=.0304, respectively). The visual acuity recovery from baseline was significantly greater in the nepafenac group (80.0%) than in the fluorometholone group (55.2%) (P=.0395). There were no serious side effects in either group.
  
  
  CONCLUSIONS
  Nepafenac was more effective than fluorometholone in preventing angiographic CME and BAB disruption, and results indicate nepafenac leads to more rapid visual recovery.
authors.affiliation: Shohzankai Medical Foundation, Miyake Eye Hospital, Kita-ku, Nagoya, Japan. miyake@spice.or.jp
authors.forename: Kensaku
authors.initials: K
authors.lastname: Miyake
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ota
authors.forename: Goichiro
authors.initials: G
authors.lastname: Miyake
authors.forename: Jiro
authors.initials: J
authors.lastname: Numaga
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D044482:Benzeneacetamides / Q000008:administration & dosage*; D018916:Blood-Aqueous Barrier / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005451:Fluorescein Angiography; D005469:Fluorometholone / Q000008:administration & dosage*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000175:diagnosis / Q000517:prevention & control*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D018918:Phacoemulsification; D010648:Phenylacetates / Q000008:administration & dosage*; D010783:Photometry; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D010648:Phenylacetates; C414203:nepafenac; D005469:Fluorometholone