title: Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery.
abstract: OBJECTIVE
  The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9 % bromfenac, 0.1 % nepafenac, 0.5 % indomethacin, or 0.1 % diclofenac) in addition to topical steroidal treatment with 0.1 % dexamethasone and 0.3 % netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation.
  
  
  METHODS
  Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy.
  
  
  METHODS
  A retrospective 6-month single center study.
  
  
  METHODS
  Patients were divided into groups according to treatment with topical drugs for 2 weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac).
  
  
  RESULTS
  Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (-1.3 %, p = 0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3 %, p = 0.04), and did not change in the groups treated with bromfenac (-1.1 %, p = 0.3), indomethacin (+0.1 %, p = 0.19), or diclofenac (+1.2 %, p = 0.74). There were no side effects in any group.
  
  
  CONCLUSIONS
  Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy. cardascia@hotmail.com.|RUO Oftalmologia, Policlinico Consorziale di Bari, p.zza G. Cesare, 11, 70124, Bari, Italy. cardascia@hotmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cardascia
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Palmisano
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy.
authors.forename: Tersa
authors.initials: T
authors.lastname: Centoducati
authors.affiliation: Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Sezione di Oftalmologia, Università degli Studi di Bari Aldo Moro, Bari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Alessio
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000009:adverse effects*; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids
keywords: Cataract; Macular edema; NSAID; OCT; Surgery