Role of Nonsteroidal Anti-Inflammatory Drugs in Prevention of Macular Edema after Uneventful Phacoemulsification in Diabetic and Non-Diabetic Patients

Abstract

Background: Pseudophakic cystoid macular edema (PCME) is one of the most important complications after cataract surgery. This can result in decreased visual acuity. Purpose: The study aimed to assess the efficacy of using Non-steroidal anti inflammatory drugs (NSAIDs) as a prophylaxis, to prevent macular edema. Patients and methods: The study included 100 eyes with cataract and accepted phacoemulsification, classified into: Group 1: Non-diabetic patients were subdivided into: (1A didn’t receive NSAIDs, 1B received NSAIDs). Group 2: Type 2 diabetic patients were subdivided into: (2A didn’t receive NSAIDs, 2B received NSAIDs). One drop of nepafenac 0.1% was administrated four times daily for 2 days before surgery, 30-120 minutes prior to surgery. Postoperatively nepafenac was given four times daily for four weeks. SD-OCT was performed to measure central macular thickness(CMT) before phacoemulsification, repeated 1 week and 1 month postoperatively. Results: In subgroup 1A; CMT increased through one month, while subgroup 1B, CMT decreased through the same time. There was significant difference in CMT between preoperative and 1week postoperative as well as between preoperative and 1 month postoperative (p=0.025, 0.037 respectively). For subgroup 2A; CMT increased through one month. There was significant difference in CMT (p<0.001) between preoperative and 1week postoperative as well as between preoperative and 1 month postoperative (p<0.008) between subgroup 2B and subgroup2A Conclusion: The prophylactic use of topical NSAIDs appears to be effective for preventing CMT change after phacoemulsification. It reduces the incidence of PCME in normal and diabetic patients and ensures a favorable outcome.