Effects of different doses of non-steroidal anti-inflammatory drugs on changes in macular thickness after micro-incision phacoemulsification

Abstract

Objective To compare the effects of different delivery methods of non-steroidal anti-inflammatory drugs (NSAIDs) on changes in macular thickness after uncomplicated micro-incision phacoemulsification using spectral domain optical coherence tomography (OCT). Methods In this prospective study, 129 patients were randomly divided into three groups. After surgery, group A (41 cases) received no NSAIDs, group B (44 cases) received pranoprofen and group C (44 cases) received pranoprofen combined with ibuprofen (sustained-release capsules). All patients were treated with topical tobramycin and dexamethasone postoperatively. OCT measurements were performed preoperatively and at 1 day, 1 week and 6 weeks postoperatively. The mean macular thicknesses of 9 sectors were analyzed with the macular thickness mapping protocol of the OCT. Data were analyzed using one-way ANOVA, repeate measured ANOVA, and Pearson correlation analysis. Results Compared with preoperative acuity, there was a significant increase in best corrected visual acuity (BCVA) after surgery in all 3 groups. However, there was no correlation between changes in macular thickness and BCVA. At 1 day after surgery, no significant differences in retinal thickness were found among the 3 groups. At 1 week after surgery, the 1-mm central subfield (CSF) thickness showed no significant difference among the groups. However, there was a significant difference in the retinal thickness of the parafoveal area (A2) between groups A and C (P<0.05). Furthermore, the thicknesses of the CSF and some parafoveal areas in group A were significantly greater than those in groups B and C (P<0.05). Conclusion NSAIDs may have some effects on alleviating macular thickening after surgery. To some extent, oral NSAIDs are effective during the early stage after surgery. Key words: Non-steroidal anti-inflammatory drugs; Macular thickness; Cystoid macular edema; Micro-incision phacoemulsification; Tomography, optical coherence