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- DOI 10.18231/j.ijceo.v.11.i.3.30
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CrossMark
Effect of topical nepafenac versus fluorometholone on macular thickness after Nd:YAG capsulotomy
- Author Details:
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Rimmi Jha
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Ashish Chander
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Priye Suman Rastogi
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Bhavika Adlakha
Rimmi Jha
Ashish Chander
Priye Suman Rastogi
Bhavika Adlakha
Background: The most common complication following an uncomplicated cataract surgery is Posterior capsular opacification (PCO). Nd:YAG (Neodymium yttrium aluminium garnet) capsulotomy is a safe, non-invasive OPD based procedure to manage an intact PCO. Transient increase in macular thickness have been an observed phenomenon following Nd:YAG capsulotomy. This study aimed to establish standard guidelines for medications to be prescribed after Nd:YAG capsulotomy to mitigate complication of increase in macular thickness & inflammation by analysing the effect of topical Nepafenac versus Fluorometholone.
Materials and Methods: A total of 96 patients diagnosed with PCO in Ophthalmology OPD of TMMC & RC, Moradabad, Uttar Pradesh, were enrolled for Nd:YAG capsulotomy over a period of one year. Optical coherence tomography was done pre and post laser to note macular thickness. Patients were randomised into group A & B and were prescribed topical Nepafenac and Fluorometholone respectively. Follow up was done after an hour, 1 week, 4 weeks, and 12 weeks and the effect of the two drugs on macular thickness was compared. Appropriate statistical tests were applied for data analysis.
Results: Total energy used during capsulotomy was in the range of 12 to 33 mJ in both the groups. The mean macular thickness at baseline was 242.7 ± 18.5 μm pre laser, which significantly increased to 268.9 ± 26.1 μm after 1 hour of treatment showing statistically significant increase compared to baseline. This gradually reduced to 259.1 ± 20.6 μm by week 12 indicating an acute increase in macular thickness after Nd:YAG capsulotomy in both the groups. There were weak to moderate correlations between total energy utilised and changes in Macular thickness. The results indicated that after Nd:YAG capsulotomy, medication is recommended, with both topical NSAIDs and topical steroids being effective options. However, topical NSAIDs may be preferred in cases where the use of steroids poses potential risks.
Conclusion: Both Nepafenac and Fluorometholone eye drops demonstrated comparable effects on acute increase in macular thickness in patients of PCO who were managed with Nd:YAG posterior capsulotomy.
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