The Effectiveness Analysis of Joint Use of Different Groups Anti-Inflammatory Drugs Treatment and Prevention of Cystoid Macular Edema in Patients after Phacoemulsification
https://doi.org/10.18008/1816-5095-2018-2-214-218
Abstract
Purpose: to analyze the results of the joint eye drops application of 0.09 % solution of bromfenac and 0.1 % solution of dexamethasone and subtenons triamcinolone injection for treatment and prevention of cystoid macular edema (CME) in patients after phacoemulsification.
Patients and methods: The study included 914 patients (1147 eyes) which held phacoemulsification with IOL implantation. Depending on the postoperative treatment patients randomized into two groups. Patients of the first group received instillation of eye drops of antibiotics-fluoroquinolones and 0.1 % dexamethasone. Patients of the second group were prescribed instillation of eye drops of 0.09 % solution of bromfenac in addition to the treatment. In each group the patients diagnosed CME after phacoemulsification were divided into subgroups depending on the presence or absence of concomitant involution of retinal pathology. In cases of diagnosis of macular edema after phacoemulsification (2nd group of patients) periocular triamcinolone injections were made.
Results. The efficacy of bromfenac was estimated by the number of cases of postoperative CME in the compared groups. In patients of the first group, complications occurred in 3.1 % of cases. In patients of the second group the number of complications was significantly lower (1.5 %), including a significant reduction in the incidence of CME observed in patients without concomitant of macular pathology (AMD and epiretinal fibrosis). A combination of steroid and NSAID in the treatment of CME provides the regression of macular edema in all patients, regardless of the presence of involution macular pathology. The positive effect of periocular triamcinolone injections in the treatment of anti-inflammatory eye drops was noted in 8 of 9 cases a month after the first injection.
About the Authors
Yu. I. PirogovRussian Federation
Sadovaya str., 126, Saint Petersburg, 194008, Russia
Universitetskaya Emb., 7/9, Saint Petersburg, 199034, Russia
PhD
A. Yu. Bovykina
Russian Federation
Litovskaya str., 2, Saint Petersburg, 194100, Russia
ophthalmologist
References
1. Conway M.D., Canakis C, Livir-Rallatos C, Peyman GA. Intravitreal triamcinolone acetonide for refractory chronic pseudophakic cystoid macular edema. J Catarac Refract Surg. 2003;29(1): 27–33. DOI: 10.1016/S0886-3350(02)01441-4
2. Астахов С.Ю., Гобеджишвили М.В. Послеоперационный макулярный отек, синдром Ирвина — Гасса. Клиническая офтальмология. 2010;1:5–10. [Astakhov S.Yu., Gobedzhishvili M.V. Postoperative macular edema, Irvine—Gass syndrome. Clinical Ophthalmology=Klinicheskaya Oftal’mologiya. 2010;1:5–10. (In Russ.)]
3. Шпак А.А., Малюгин Б.Э., Фадеева Т.В. Влияние желтого светофильтра ИОЛ на состояние макулярной зоны после факоэмульсификации катаракты у пациентов с возрастной макулярной дегенерацией. Вестник офтальмологии. 2012;4:48–51. [Shpak A.A., Malyugin B.E., Fadeeva T.V. The influence of IOL with yellow optical filters on post-op patients’ macular zone with age-specific macular degeneration. Annals of Ophthalmology=Vestnik Oftal’mologii. 2012;4:48–51. (In Russ.)]
4. American Academy of Ophthalmology Cataract and Anterior Segment Panel. Preferred Practice Pattern® Guidelines. Cataract in the Adult Eye. San Francisco, CA: American Academy of Ophthalmology; 2011.
5. Lobo C.L., Faria P.M., Soares M. A., Bernardes R.C., Cunda — Vaz J. G. Macular alterations after small-incision cataract surgery. J. Cataract Refract. Surg. 2004;30:752–60. DOI: 10.1016/S0886-3350(03)00582-0
6. Пирогов Ю.И., Бутина Г.М., Морозов Р.А., Оксентюк А.А., Рыбина М.В., Чшиева М.Р., Шаталов М.С. Опыт применения нестероидного противовоспалительного препарата, содержащего бромфенак, у пациентов после хирургии катаракты. Офтальмологические ведомости. 2016;9(2):53–56. [Pirogov Yu.I., Butina G.M., Morozov R.A., Oksentyuk A.A., Rybina M.V., Chshieva M.R., Shatalov M.S. Experience with nonsteroidal anti-inflammatory drugs provided bromfenak of patients after cataract surgery. Journal of ophthalmology=Oftal’mologicheskie vedomosti. 2016;9(2):53–56. (In Russ.)] DOI: 10.17816/OV9253-56
7. Giansanti F., Bitossi A., Giacomelli G., Virgili G., Pieretti G., Giuntoli M., Abbruzzese G., Menchini U. Evaluation of macular thickness after uncomplicated cataract surgery using optical coherence tomography. Eur J Ophthalmol. 2013;751–6. DOI: 10.5301/ejo.5000280
8. Малюгин Б.Э., Шпак А.А., Морозова Т.А. Хирургия катаракты: клинико-фармакологические подходы. Москва: Офтальмология, 2015;82. [Malyugin B.E., Shpak A.A., Morozova T.A. Cataract surgery: clinical pharmacology studies. Moscow: Ophthalmology, 2015:82. (In Russ.)]
9. Cable M. Comparison of bromfenac 0.09% QD to nepafenac 0.1% TID after cataract surgery: pilot evaluation of visual acuity, macular volume, and retinal thickness at a single site. Clin. Ophthalmol. 2012;6:997–1004. DOI: 10.2147/OPTH.S32179
10. Palacio C., Fernández De Ortega L., Bustos F.R., Chávez E., Oregon-Miranda A.A., Mercado-Sesma A.R. Bromfenac 0.09% bioavailability in aqueous humor, prophylactic effect on cystoid macular edema, and clinical signs of ocular inflammation after phacoemulsification in a Mexican population. Clin Ophthalmol. 2016;10:233–7. DOI: 10.2147/OPTH.S93530
11. Wang Q.W., Yao K., Xu W., et al. Bromfenac sodium 0.1%, fluorometholone 0.1% and dexamethasone 0.1% for control of ocular inflammation and prevention of cystoid macular edema after phacoemulsification. Ophthalmologica. 2013;229(4):187–94. DOI: 10.1159/000346847
12. Henderson, B.A., Kim, J.Y., Ament, C.S., Ferrufino-Ponce, Z.K., Grabowska, A. & Cremers, S.L. Clinical pseudophakic cystoid macular edema Risk factors for development and duration after treatment. J Cataract Refract Surg. 2007;33(9):1550–8. DOI: 10.1016/j.jcrs.2007.05.013
13. Jung J.W., Chung B.H., Kim E.K., Seo K.Y., Kim T.I. The effects of two non-steroidal anti- inflammatory drugs, bromfenac 0.1% and ketorolac 0.45%, on cataract surgery. Yonsei Med J. 2015;56(6):1671–77. DOI: 10.3349/ymj.2015.56.6.1671
Review
For citations:
Pirogov Yu.I., Bovykina A.Yu. The Effectiveness Analysis of Joint Use of Different Groups Anti-Inflammatory Drugs Treatment and Prevention of Cystoid Macular Edema in Patients after Phacoemulsification. Ophthalmology in Russia. 2018;15(2):214-218. (In Russ.) https://doi.org/10.18008/1816-5095-2018-2-214-218