title: The assessment of changes in macular thickness in diabetic and non-diabetic patients: the effect of topical ketorolac on macular thickness change after ND:YAG laser capsulotomy.
abstract: OBJECTIVE
  The purpose of our study is to assess the changes in macular thickness (MT) in diabetic and non-diabetic patients and to research effects of topical ketorolac (Acular®, Allergan, Irvine, CA) on MT change after neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy.
  
  
  METHODS
  This study involved 88 eyes of 88 patients diagnosed as posterior capsule opacification (PCO). Patients were divided into four groups according to presence of diabetes mellitus (DM) and drugs used after capsulotomy. Group 1: Patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (22 patients). Group 2: Patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (20 patients). Group 3: Patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (22 patients). Group 4: Patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (24 patients). A plus-shaped capsulotomy was performed using VISULAS® YAGIII (Carl Zeiss) laser microscope. MT measurement with Cirrus SD-OCT (Carl Zeiss Opthalmic System Inc., Model 400, Dublin, CA, Software 5) were done. Measurements were done before laser, and on the first day, first week, first month, third month and sixth month after laser capsulotomy. We compared the four groups for MT change during 6 months.
  
  
  RESULTS
  Group 1 involving patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy had increased MT at the first week, and the first, third, and sixth month after laser (p < 0.001). Group 3 involving patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) had increased MT at the first week, and at the first and third month, there was no statistically significant difference at the sixth month (p > 0.05). There was no statistically significant increase in MT during the follow-up period in group 2 involving patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy and group 4 involving patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (p > 0.05).
  
  
  CONCLUSIONS
  An increase in MT can be observed after Nd:YAG laser capsulotomy, especially in diabetic patients. Adding topical ketorolac (Acular®, Allergan, Irvine, CA) to topical Fluorometholon (FML®, Allergan, Irvine, CA) therapy after YAG laser capsulotomy can prevent this increase.
authors: a Niğde State Hospital , Nigde , Turkey and.
authors: Uğur
authors: U
authors: Yılmaz
authors: a Niğde State Hospital , Nigde , Turkey and.
authors: Erkut
authors: E
authors: Küçük
authors: b Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Döndü Melek
authors: DM
authors: Ulusoy
authors: b Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Ayşe
authors: A
authors: Özköse
authors: b Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Mustafa
authors: M
authors: Ataş
authors: b Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Süleyman
authors: S
authors: Demircan
authors: b Kayseri Training and Research Hospital , Kayseri , Turkey.
authors: Isa
authors: I
authors: Yuvacı
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D058442:Capsule Opacification / Q000188:drug therapy / Q000628:therapy; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use*; D053844:Lasers, Solid-State; D008266:Macula Lutea / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064727:Posterior Capsulotomy / Q000009:adverse effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac
keywords: Capsulotomy; Nd:YAG laser; ketorolac; posterior capsule opacification