Abstract
Background To evaluate the effects of topical 0.5% ketorolac treatment combined with topical steroids on macular thickness in cases who had uneventful phacoemulsification surgery. Methods 58 eyes of 58 consecutive cases were included. The mean foveal thickness (MFT), parafoveal thickness (ParaFT), and perifoveal thickness (PeriFT) measurements were performed with optical coherence tomography (RTVue-100, Optovue, Fremont, CA, USA) preoperatively and at postoperative 1 week, 1 month, and 2 months. All cases received topical 0.1% dexamethasone postoperatively. Randomly selected cases additionally received topical 0.5% ketorolac, which started 2 days prior to surgery. Cases who received both topical steroids and ketorolac formed group 1 and subjects who received only topical steroids formed group 2. Results The increase in mean MFT at the 1st week, 1st month, and 2nd months after surgery in group 1 was significantly lower than group 2 (P = 0.008, P ≤ 0.001, and P ≤ 0.001, resp.). In group 1, the increase in mean ParaFT and PeriFT was significantly lower than group 2 at the 1st and 2nd months of the surgery (P < 0.05 for all variables). Conclusions Topical ketorolac combined with steroids is highly efficacious in order to prevent increment in thickness on each part of the macula even after an uneventful phacoemulsification surgery comparing to steroid monotheraphy.
Highlights
Cystoid macular edema (CME) is the most common cause of decreased visual acuity after uneventful cataract surgery
Two eyes from group 2 were excluded from the statistical analyses because of the development of cystoid macular edema (CME) detected by Optical coherence tomography (OCT) evaluation, one of them being clinically significant macular edema (CSME)
All the macular thickness parameters including mean foveal thickness (MFT), parafoveal thickness (ParaFT), and perifoveal thickness (PeriFT) were significantly higher in these two eyes than that in the rest of the study group
Summary
Cystoid macular edema (CME) is the most common cause of decreased visual acuity after uneventful cataract surgery. Histopathological studies have supported the role of inflammation in the pathophysiology of both cystoid and diffuse macular edema (ME) developing after cataract surgery [4, 5]. The purpose of the present study was to objectively evaluate the effects of topical 0.5% ketorolac in combination with topical steroids on macular thickness changes, in cases that had uneventful phacoemulsification and intraocular lens (IOL) implantation, measured by the Fourier domain OCT. To evaluate the effects of topical 0.5% ketorolac treatment combined with topical steroids on macular thickness in cases who had uneventful phacoemulsification surgery. Selected cases received topical 0.5% ketorolac, which started 2 days prior to surgery. Topical ketorolac combined with steroids is highly efficacious in order to prevent increment in thickness on each part of the macula even after an uneventful phacoemulsification surgery comparing to steroid monotheraphy
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