Subconjunctival dexamethasone for the prevention of cystoid macular oedema in routine cataract surgery: a randomised and controlled trial

Session Details

Session Title: Cataract Surgery Paediatric/Complications/Management

Session Date/Time: Monday 09/10/2017 | 16:30-18:00

Paper Time: 17:35

Venue: Room 4.1

First Author: : E.Kocak AUSTRALIA

Co Author(s): :    A. Hall   D. van der Straaten                 

Abstract Details

Purpose:

Cystoid macular oedema (CMO) is a common complication causing visual loss following cataract surgery. Subconjunctival dexamethasone is used in patients at high risk of developing CMO, however its role in patients with no risk factors for CMO development has not been evaluated. We performed a prospective, randomised, controlled, investigator-masked, single centre clinical trial to test the hypothesis that injection of intra-operative subconjunctival dexamethasone prevents the development of CMO following routine uncomplicated cataract surgery.

Setting:

Department of Ophthalmology at The Alfred Hospital, Melbourne, Australia

Methods:

Eyes of patients scheduled to undergo cataract surgery with no known risk factors for development of CMO were randomised to receive either the current standard of care (control group; n=91) or the current standard of care plus a single subconjunctival depot injection of 1 mg dexamethasone at the conclusion of cataract surgery (dexamethasone group; n=118). All patients received steroid eyedrops post-operatively. The primary outcome was the mean change in central macular thickness (CMT), evaluated using optical coherence tomography at 1 week. Secondary outcomes were the incidence of clinical CMO, best-corrected visual acuity (BCVA), intraocular inflammation, and intraocular pressure.

Results:

Mean change in CMT was similar between the two groups (1.9±20.0 µm in the control group compared to 1.7±13.5 µm in the dexamethasone group; P=0.931). Clinical CMO was present in 2 eyes (2.2%) in the control group and 1 eye (0.8%) in the dexamethasone group (P=0.581). BCVA at 1 week was 0.09±0.14 logMAR in the control group and 0.09±0.18 logMAR in the dexamethasone group (P=0.630). There were no statistically significant differences between the groups in the level of post-operative intraocular inflammation (P=0.693), change in intraocular pressure (P=0.944) or frequency of adverse events (P=0.828).

Conclusions:

Subconjunctival dexamethasone was not efficacious in preventing CMO or reducing intraocular inflammation following routine cataract surgery. It was not associated with an increase in post-operative complications or adverse effects.

Financial Disclosure:

NONE

Financial Disclosure:

NONE