title: A comparison of preservative-free diclofenac and preserved diclofenac eye drops after cataract surgery in patients with diabetic retinopathy.
abstract: OBJECTIVE
  The aim of this study was to compare the anti-inflammatory efficacy of preservative-free and preserved 0.1% diclofenac eye drops for the management of postoperative inflammation after cataract surgery in patients with nonproliferative diabetic retinopathy and in normal controls.
  
  
  METHODS
  Forty-two diabetic patients and 50 normal control patients who underwent small-incision phacoemulsification cataract surgery bilaterally received topical preservative-free diclofenac in 1 eye and preserved diclofenac in the other eye. The corrected distance visual acuity (CDVA) as determined by a logarithm of the minimum angle of resolution (logMAR) chart, intraocular pressure (IOP), foveal thickness (FT) using optical coherence tomography (OCT), and the anterior chamber flare (ACF) score measured with a laser flare cell meter were monitored for 12 weeks after surgery.
  
  
  RESULTS
  In the eyes with diabetic retinopathy, there were no significant differences in CDVA, IOP, FT, and ACF score between the right and left eyes at the initial exam. After cataract surgery, changes in CDVA, IOP, and FT were not influenced by the preservative in the diclofenac eye drops. In contrast, the ACF score in the eyes treated with preserved diclofenac showed slower recovery from postoperative inflammation than the eyes treated with preservative-free diclofenac. In the normal control eyes, similar but milder changes were observed in each of the clinical parameters.
  
  
  CONCLUSIONS
  Because preservative suppressed the anti-inflammatory efficacy of topical diclofenac after cataract surgery, preservative-free diclofenac may have an improved safety profile during postoperative treatment, especially in patients with diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Miyagi, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Yasuda
authors.forename: Akiko
authors.initials: A
authors.lastname: Miyazawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D002386:Cataract / Q000628:therapy*; D002387:Cataract Extraction / Q000379:methods; D003930:Diabetic Retinopathy / Q000601:surgery*; D004008:Diclofenac / Q000008:administration & dosage*; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D007429:Intraocular Pressure / Q000187:drug effects; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D018918:Phacoemulsification / Q000379:methods; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D004008:Diclofenac