Comparison of ketorolac 0.4% and nepafenac 0.1% for the prevention of cystoid macular oedema after phacoemulsification: prospective placebo-controlled randomised study.
OBJECTIVE
To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4% and nepafenac 0.1% eye drops for prophylaxis of cystoid macular oedema (CME) after small-incision cataract extraction.


METHODS
Patients were assigned randomly to three groups. Group 1 patients received a topical artificial tear substitute (placebo); group 2 received ketorolac tromethamine 0.4% (Acular LS, Allergan) and group 3 received nepafenac 0.1% (Nevanac, Alcon). The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography (OCT) after 1, 4 and 12 weeks.


RESULTS
One hundred and twenty-six eyes of 126 patients were included in this study. The between-group differences in visual outcomes, central corneal thickness and endothelial cell density were not statistically significant. In all retinal thickness measurements, an increase was detected starting from the postoperative first week until 12 weeks. There was no statistically significant difference between the three groups in any measurement performed by spectral-domain OCT.


CONCLUSIONS
Used prophylactically after uneventful cataract surgery, non-steroidal anti-inflammatory drugs were not efficacious in preventing macular oedema compared with placebo.


BACKGROUND
ClinicalTrials: NCT02084576.
Brasilia Ophthalmologic Hospital, HOB, Brasilia, DF, Brazil.
Patrick Frensel
PF
Tzelikis
Brasilia Ophthalmologic Hospital, HOB, Brasilia, DF, Brazil.
Monike
M
Vieira
Brasilia Ophthalmologic Hospital, HOB, Brasilia, DF, Brazil Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Wilson Takashi
WT
Hida
Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Antonio Francisco
AF
Motta
Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Celso Takashi
CT
Nakano
Brasilia Ophthalmologic Hospital, HOB, Brasilia, DF, Brazil.
Eliane Mayumi
EM
Nakano
Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Milton Ruiz
MR
Alves
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D044482:Benzeneacetamides / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000008:administration & dosage / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000175:diagnosis / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D010648:Phenylacetates / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012160:Retina / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D009883:Ophthalmic Solutions; D010648:Phenylacetates; C414203:nepafenac; D020910:Ketorolac