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Abstract #104693 Published in IGR 23-2
COMPARISON OF POST CATARACT SURGERY ANTI-INFLAMMATORY REGIMENS ON THE INCIDENCE OF CYSTOID MACULAR EDEMA, IRITIS, PAIN, AND PHOTOPHOBIA
Visco DMJournal of Cataract and Refractive Surgery 2023; 49: 44-49
PURPOSE: To compare post-cataract surgery anti-inflammatory regimens of intracanalicular dexamethasone insert and topical bromfenac on the incidence of cystoid macular edema (CME), iritis, pain, and photophobia. SETTING: Eyes of York Cataract & Laser Center, York, PA, USA. DESIGN: Retrospective chart review. METHODS: Case records of 647 consecutive patients (1001 eyes) who underwent cataract surgery and received dexamethasone intracanalicular insert 0.4 mg (group 1; 482 eyes) or topical non-steroidal anti-inflammatory drug (NSAID) (bromfenac 0.075% BID) for four weeks postoperatively (group 2; 519 eyes) were included. Both groups received intracameral moxifloxacin and phenylephrine/ketorolac. Patients with prior CME, vitreomacular traction, combined cataract/glaucoma surgery, and medication protocols different from those examined in this study were excluded. RESULTS: Compared with the dexamethasone insert group, the topical NSAIDs group had significantly lower incidence of CME (0.4% (2/519) vs 3.9% (19/482), P<.001) and photophobia (1.9% (10/519) vs 4.8% (23/482), P=0.012). The incidence of breakthrough iritis (3.5% (18/519) vs 5.6% (27/482), P=0.104) and pain also trended lower (4.0% (21/519) vs 5.4% (26/482), P=0.314) in the topical NSAID group. CONCLUSION: Topical NSAIDs were found to be more effective in controlling CME, pain, iritis, and photophobia after cataract surgery compared with the intracanalicular dexamethasone insert in the presence of intracameral phenylephrine/ketorolac.
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