Single perioperative subconjunctival steroid depot versus postoperative steroid eyedrops to prevent intraocular inflammation and macular edema after cataract surgery

Myrthe Dieleman, René J Wubbels, Marina van Kooten-Noordzij, Peter W T de Waard

Research output: Contribution to journalArticleResearchpeer-review

Abstract

PURPOSE: To compare the efficacy of dexamethasone 0.1% eyedrops after phacoemulsification versus a single perioperative subconjunctival injection of betamethasone acetate 5.7 mg/mL to prevent anterior segment inflammation and macular edema.

SETTING: Rotterdam Eye Hospital, Rotterdam, The Netherlands.

DESIGN: Randomized clinical trial.

METHODS: Patients scheduled for cataract surgery were randomly assigned to receive a perioperative subconjunctival injection of betamethasone acetate 5.7 mg/mL (Group 1) or postoperative administration of dexamethasone 0.1% eyedrops (Group 2). Primary outcomes were foveal thickness and macular edema on optical coherence tomography (OCT) and anterior chamber flare by a laser flare meter preoperatively and 4 weeks postoperatively. Secondary outcomes were intraocular pressure, need for additional outpatient clinic visits, phacoemulsification energy, verbal-rating pain scale, and corrected distance visual acuity.

RESULTS: The study enrolled 400 patients (400 eyes). Four weeks postoperatively, the mean flare values were significantly higher in Group 1 than in Group 2 (P=.003). The incidence of macular edema on OCT and clinically significant macular edema were not significantly different between groups (P=.685 and P=.386, respectively). No significant difference was observed in any other outcome measure.

CONCLUSION: A single subconjunctival betamethasone acetate injection appears to be a useful alternative to prolonged postoperative administration of dexamethasone eyedrops in controlling intraocular inflammation and development of macular edema after phacoemulsification.

Original languageEnglish
Pages (from-to)1589-97
Number of pages9
JournalJournal of Cataract and Refractive Surgery
Volume37
Issue number9
DOIs
Publication statusPublished - Sep 2011

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Betamethasone/administration & dosage
  • Dexamethasone/administration & dosage
  • Female
  • Follow-Up Studies
  • Glucocorticoids/administration & dosage
  • Humans
  • Injections, Intraocular
  • Intraocular Pressure/physiology
  • Macular Edema/prevention & control
  • Male
  • Middle Aged
  • Ophthalmic Solutions/administration & dosage
  • Phacoemulsification
  • Photometry
  • Postoperative Complications/prevention & control
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Uveitis, Anterior/prevention & control
  • Visual Acuity/physiology

Fingerprint

Dive into the research topics of 'Single perioperative subconjunctival steroid depot versus postoperative steroid eyedrops to prevent intraocular inflammation and macular edema after cataract surgery'. Together they form a unique fingerprint.

Cite this