Journal ArticleDOI
Treatment of acute pseudophakic cystoid macular edema: Diclofenac versus ketorolac.
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TLDR
Diclofenac sodium 0.1% solution and ketorolac tromethamine 0.5% topical ophthalmic solution eyedrops were equally effective in reducing the severity and duration of CME after uneventful phacoemulsification with posterior chamber IOL implantation.Abstract:
Purpose: To investigate whether topical diclofenac sodium 0.1% solution (Voltaren Ophthalmic®) is as efficacious as topical ketorolac tromethamine 0.5% solution (Acular®) in the treatment of established, chronic cystoid macular edema (CME) after uneventful phacoemulsification cataract extraction with posterior chamber intraocular lens (IOL) implantation.
Setting: Referral-based vitreoretinal private practice.
Methods: This randomized prospective study comprised 34 consecutive patients with clinical CME after uneventful phacoemulsification cataract extraction with posterior chamber IOL implantation who were referred to a private vitreoretinal practice for evaluation and management. Exclusion criteria included a history of previous intraocular surgery, vitreous loss during cataract surgery, CME, uveitis, and vitreoretinal pathology. The eye with CME was treated with 1 drop 4 times daily of diclofenac sodium 0.1% solution or ketorolac tromethamine 0.5% solution. Outcomes were measured by observing for improvement in CME and visual acuity.
Results: Both treatment methods resulted in a significant reduction in CME and a significant improvement in visual acuity. Within 26 weeks, diclofenac reduced CME in 16 patients (89%) and ketorolac, in 14 patients (88%) (P = .92, confidence interval [CI] 95%). Within 26 weeks, diclofenac eliminated CME in 14 patients (78%) and ketorolac, in 12 patients (75%) (P = .86, CI 95%). The mean time to initial CME reduction was 7.5 weeks with diclofenac and 8.0 weeks with ketorolac (P = .41, CI 95%). The mean time to CME resolution was 13.6 weeks with diclofenac and 12.8 weeks with ketorolac (P = .49, CI 95%).
Conclusions: Diclofenac sodium 0.1% solution and ketorolac tromethamine 0.5% topical ophthalmic solution eyedrops were equally effective in reducing the severity and duration of CME after uneventful phacoemulsification with posterior chamber IOL implantation. Either solution may be considered for CME after cataract surgery, especially in patients who may not tolerate corticosteroid treatment.read more
Citations
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Journal ArticleDOI
Nonsteroidal Anti-inflammatory Drugs in Ophthalmology
TL;DR: An updated review on NSAIDs and a summary of their current uses in ophthalmology with attention to potential future applications suggests therapeutic effects on diabetic retinopathy and age-related macular degeneration may now be achievable.
Journal ArticleDOI
Cataract in the Adult Eye Preferred Practice Pattern
Randall J. Olson,Rosa Braga-Mele,Sherleen H. Chen,Kevin M. Miller,Roberto Pineda,James P. Tweeten,David C. Musch +6 more
Journal ArticleDOI
Clinical pseudophakic cystoid macular edema. Risk factors for development and duration after treatment.
Bonnie An Henderson,Jae Yong Kim,Christine Shortsleeve Ament,Zandra K. Ferrufino-Ponce,Anna Grabowska,Sandra Lora Cremers +5 more
TL;DR: In this article, the effects of treatment regimens on visual outcome and duration of CME after cataract surgery were investigated and the incidence of post-operative CME was 2.35% (39/1659).
Risk factors for development and duration after treatment
Bonnie An Henderson,Jae Yong Kim,Christine Shortsleeve Ament,Zandra K. Ferrufino-Ponce,Anna Grabowska,Sandra Lora Cremers +5 more
TL;DR: A history of RVO, ERM, and preoperative prostaglandin use were associated with an increased risk for pseudophakic CME and treatment with NSAIDs plus steroids was associated with faster resolution of CME than no treatment.
Journal ArticleDOI
Pseudophakic cystoid macular edema.
TL;DR: Though the precise mechanistic details underlying pseudophakic CME remain to be elucidated, 2 primary hypothetical components have been implicated in its pathogenesis and the first of these is ocular inflammation, as alluded to by Irvine’s classical description of an ‘‘irritated’’ eye.
References
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Journal ArticleDOI
Treatment of Chronic Macular Edema With Acetazolamide
TL;DR: Sixteen patients showed a reproducible response to acetazolamide with partial or complete resolution of edema and improvement of visual acuity, and the therapeutic effect occurred in more than half of the patients with inherited outer retinal disease or uveitis, but in none with primary retinal vascular disorders.
Journal Article
The incidence, pathogenesis and treatment of cystoid macular edema following cataract surgery.
Journal ArticleDOI
Prevention of cystoid macular edema after lens extraction by topical indomethacin (I). A preliminary report.
TL;DR: Topically administered indomethacin was found to reduce the occurrence of cystoid macular edema after lens extraction as mentioned in this paper, which suggests that prostaglandins play a leading role in the development of this disorder.
Journal ArticleDOI
Improvement in Visual Acuity in Chronic Aphakic and Pseudophakic Cystoid Macular Edema After Treatment With Topical 0.5% Ketorolac Tromethamine
Allan J. Flach,Lee M. Jampol,David V. Weinberg,Manus C. Kraff,Lawrence A. Yannuzzi,Randy V. Campo,Albert C. Neumann,Howard P. Cupples,W. Hampton Lefler,Jose S. Pulido,Caroline J. Lavelle +10 more
TL;DR: Evidence is offered for a more optimistic outlook in the medical treatment of chronic aphakic and pseudophakic cystoid macular edema by ketorolac tromethamine 0.5% ophthalmic solution treatment.