Use of Nepafenac with Conventional Topical Antibiotic-Steroid combination in Post Cataract Surgery Regimen.

Abstract

Purpose of study: This study was conducted to evaluate the role of Nepafenac in reducing the inflammation and macular edema after Phacoemulsification along with conventional antibiotic-steroid therapy.

Materials and Methods This prospective randomized control trial study was conducted from jan 2019 to Dec 2019 on 500 patients with senile cataract undergoing Phacoemulsification. Out of 500 patients 223 patients were males while 277 were females. After Phacoemulsification the patients were divided into two groups. Group A with 250 patients was given antibiotic- steroid combination while Group B with 250 patients was given nepafenac along with antibiotic- steroid combination for a period of 7 weeks postoperative. Serial examination was conducted after Phacoemulsification including slit lamp examination with biomicroscopy, visual acuity testing, Tonometry, and finally OCT on last visit.

Results The two groups were compared with regard to visual acuity, intraocular pressure, anterior chamber reaction and cells and central macular thickness. The best corrected visual acuity was 6/6-6/9 in 90% in group A while 96% in group B at final visit. Inflammatory cells and flare in the anterior chamber were nearly equal in both groups at 1" postoperative day (P>0.05), but there was significant statistical difference in the same at 2“ and 3" follow up(P<0.05). At the last follow up that is 6" postoperative week again no statistical difference was found in the cells and flare in the anterior chamber (P>0.05) in both groups. The intraocular pressure spiked in group A in 8(3.2%) patients at 6"' follow up as compared to 2(0.8%) patients in group

1. The mean central macular thickness was higher in group A at 6" week as compared to Group B.

Conclusion: Nepafenac as an addition to topical steroids have a beneficial effect on reducing immediate postoperative inflammation. Reducing the frequency of steroids with nepafenac also decreases the chances of steroid response glaucoma. Finally nepafenac poses it's additive effect by reducing the chances of postoperative macular edema.