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.
|Number of pages||9|
|Journal||Journal of Cataract and Refractive Surgery|
|Publication status||Published - Sep 2011|
- Aged, 80 and over
- Betamethasone/administration & dosage
- Dexamethasone/administration & dosage
- Follow-Up Studies
- Glucocorticoids/administration & dosage
- Injections, Intraocular
- Intraocular Pressure/physiology
- Macular Edema/prevention & control
- Middle Aged
- Ophthalmic Solutions/administration & dosage
- Postoperative Complications/prevention & control
- Tomography, Optical Coherence
- Treatment Outcome
- Uveitis, Anterior/prevention & control
- Visual Acuity/physiology