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

Purpose: To examine preoperative anti-inflammatory treatment on recovery from cataract surgery in eyes of diabetic patients. Methods: 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 (10 mg/ml) and nepafenac (1 mg/ml). All eyes received postoperative anti-inflammatory combination therapy for 3 weeks. Recovery from surgery was recorded by a structured home questionnaire. Clinical outcome parameters were recorded at 28 days and 3 months. Results: 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 AE 1.7 days (mean AE SD) and irritation of the eye 3.3 AE 3.9 days in eyes without preoperative treatment, when compared to 1.6 AE 1.6 days (p = 0.067) and 2.4 AE 4.0 days (p = 0.431), respectively, in eyes with preoperative treatment. At 28 days, central subfield macular thickness (CSMT) increased 2.2 AE 20.2 lm in eyes without preoperative treatment, when compared 0.1 AE 25.2 lm (p = 0.670) in eyes with preoperative treatment. At 3 months, the respective CSMT change from baseline was À1.5 AE 26.9 lm and À3.4 AE 26.2 lm (p = 0.762). None of the eyes were reported with pseudophakic cystoid macular oedema (PCME) in either group. Conclusion: 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.

Clinical outcomes for measuring inflammatory response after cataract surgery

“…Another recent study by Danni et al (2019) made similar observations in aqueous flare values in diabetic patients after cataract surgery. Laser flare metre revealed lower aqueous flare at 28 days postoperatively in the group of patients that had preoperatively received a combination of prednisolone acetate and nepafenac compared to the group that had not received any preoperative anti‐inflammatory medication.…”

Salvadora persica protects mouse intestine from eimeriosis

“…In our gas chromatography-mass spectrometry analysis, prednisolone acetate was identified as a component in SE. This compound is used as an anti-inflammatory agent (DANNI et al, 2019).…”

Effect of preoperative topical nepafenac 0.1% on inflammatory response after uncomplicated cataract surgery in healthy subjects

“…In diabetic patients, the incidence of PCME was reduced and visual outcomes were better when nepafenac was started 1 day before and continued 90 days after surgery (Singh et al 2012). In a recent paper, Danni et al investigated the efficacy of preoperative combined treatment with prednisolone acetate 10 mg/ml and Nepafenac 1 mg/ml in diabetic patients (Danni et al 2019). They concluded that, when the postoperative treatment is adequate, the preoperative anti‐inflammatory treatment does not improve recovery from cataract surgery and does not reduce the risk of PCME in diabetic patients.…”