Do non-steroidal anti-inflammatory drugs added to steroid treatment lower the number of unplanned postoperative visits after phacoemulsification? A two-centre comparative cohort study

Session Details

Session Title: Cataract Surgery: Complications & Management

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:50

Venue: Free Paper Forum: Podium 1

First Author: : B.Johansson SWEDEN

Co Author(s): :    J. Gärdin                             

Abstract Details

Purpose:

To study the incidence of unplanned postoperative controls after phacoemulsification at two adjacent public health care financed clinics with dissimilar protocols for postoperative anti-inflammatory treatment.

Setting:

The departments of ophthalmology at two public financed hospitals in the County of Östergötland, Sweden: Linköping University Hospital and Vrinnevi Hospital, Norrköping.

Methods:

500 consecutive operations per site were selected through electronic medical record system, from start 2015. Postoperative topical treatment was NSAID + steroid for 3 weeks at one site (group 1), and steroids only for 3 weeks at the other (Group 2). Exclusion criteria were posterior capsular rupture, ocular malformation, and postoperative treatment outside routines at respective clinic. Primary outcome was number of unplanned postoperative controls during 6 first postoperative months due to cystoid macular edema (CME), elevated intra-ocular pressure (IOP), iridocyclitis, corneal edema, or other causes. Secondary outcomes were visual acuity and intraocular pressure at postoperative control.

Results:

Eighty-four unplanned controls occurred in group 1 (16.8% of enrolled eyes), versus 63 (12.6%) in group 2. Corneal edema - reversible in most cases - occurred in 12 of group 1 eyes (2.4%), and 11 (2.2%) of group 2 eyes. Intra-ocular pressure was elevated in 14 group 1 eyes (2.8%), and in 5 group 2 eyes (1.0%). Increased or prolonged iridocyclitis affected 8 eyes (1,6%) in group 1 and 13 eyes (2.6%) in group 2. CME necessitated extra controls and treatment for 8 eyes (1.6%) in group 1, versus 6 eyes (1.2%) in group 2.

Conclusions:

The results indicate that the need for unplanned postoperative controls due to complications - including visually disturbing CME - after phacoemulsification surgery, is not reduced when NSAID is added to steroids as postoperative anti-inflammatory treatment in an unselected population.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company