Document Detail

Single perioperative subconjunctival steroid depot versus postoperative steroid eyedrops to prevent intraocular inflammation and macular edema after cataract surgery.
MedLine Citation:
PMID:  21855759     Owner:  NLM     Status:  In-Data-Review    
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.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
Myrthe Dieleman; René J Wubbels; Marina van Kooten-Noordzij; Peter W T de Waard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  37     ISSN:  1873-4502     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1589-97     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
From Rotterdam Ophthalmic Institute (Dieleman, Wubbels), the Department of Ophthalmology (van Kooten-Noordzij), University Hospital Maastricht, and the Rotterdam Eye Hospital (de Waard), Rotterdam, The Netherlands.
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