Preoperative anti-inflammatory treatment of diabetic patients does not improve recovery from cataract surgery when postoperatively treated with a combination of prednisolone acetate and nepafenac.

Abstract

To examine preoperative anti-inflammatory treatment on recovery from cataract surgery in eyes of diabetic patients. A Prospective randomized clinical trial. One hundred and three eyes of 103 patients with diabetes undergoing routine cataract surgery were randomized (1:1) not to receive any preoperative anti-inflammatory medication or to receive preoperative topical anti-inflammatory medication with a combination of prednisolone acetate (10mg/ml) and nepafenac (1mg/ml). All eyes received postoperative anti-inflammatory combination therapy for 3weeks. Recovery from surgery was recorded by a structured home questionnaire. Clinical outcome parameters were recorded at 28days and 3months. Patient age and gender distribution, and all baseline ophthalmic and systemic parameters were comparable between the study groups. After surgery, conjunctival injection lasted 2.4±1.7days (mean±SD) and irritation of the eye 3.3±3.9days in eyes without preoperative treatment, when compared to 1.6±1.6days (p=0.067) and 2.4±4.0days (p=0.431), respectively, in eyes with preoperative treatment. At 28days, central subfield macular thickness (CSMT) increased 2.2±20.2μm in eyes without preoperative treatment, when compared 0.1±25.2μm (p=0.670) in eyes with preoperative treatment. At 3months, the respective CSMT change from baseline was -1.5±26.9μm and -3.4±26.2μm (p=0.762). None of the eyes were reported with pseudophakic cystoid macular oedema (PCME) in either group. Lack of preoperative anti-inflammatory treatment does not impair recovery from surgery or predispose diabetic patients to increased risk of PCME in eyes postoperatively treated with combination therapy of prednisolone acetate and nepafenac.