Eighteen eyes with vitreous strands adherent to the corneoscleral wounds of previous cataract surgery were treated with neodymium: YAG laser to lyse those strands. Twelve eyes were treated for management of cystoid macular edema (CME group); six eyes were treated for prophylaxis of possible CME (prophylactic group). In the CME group, visual acuity improved two or more lines in nine eyes (75.0%), and seven eyes had a post laser visual acuity of 0.5 or better (One eye had a pre-treatment visual acuity of 0.5 or better). In the prophylactic group, visual acuity was either maintained at the pre-treatment visual acuity of 0.5 or better. In the prophylactic group, visual acuity was either maintained at the pre-treatment level or improved in five eyes (83.3%) 18 months later following laser treatment. This procedure was complicated by retinal detachment in one case and the elevation of intraocular pressure over 10 mmHg in another case.
Adult ; Aged ; Aged, 80 and over ; Cataract Extraction/adverse effects ; Eye Diseases/etiology/surgery ; Female ; Humans ; *Laser Therapy ; Macular Edema/prevention & control/*surgery ; Male ; Middle Aged ; Visual Acuity ; Vitreous Body/*surgery

PURPOSE: To compare the additive effects of two types of non-steroidal anti-inflammatory drugs (NSAIDs), bromfenac 0.1% or ketorolac 0.45%, relative to topical steroid alone in cataract surgery. MATERIALS AND METHODS: A total 91 subjects scheduled to undergo cataract operation were randomized into three groups: Group 1, pre/postoperative bromfenac 0.1%; Group 2, pre/postoperative preservative-free ketorolac 0.45%; and Group 3, postoperative steroid only, as a control. Outcome measures included intraoperative change in pupil size, postoperative anterior chamber inflammation control, change in macular thickness and volume, and ocular surface status after operation. RESULTS: Both NSAID groups had smaller intraoperative pupil diameter changes compared to the control group (p<0.05). There was significantly less ocular inflammation 1 week and 1 month postoperatively in both NSAID groups than the control group. The changes in central foveal subfield thickness measured before the operation and at postoperative 1 month were 4.30+/-4.25, 4.87+/-6.03, and 12.47+/-12.24 microm in groups 1 to 3, respectively. In the control group, macular thickness and volume increased more in patients with diabetes mellitus (DM), compared to those without DM. In contrast, in both NSAID groups, NSAIDs significantly reduced macular changes in subgroups of patients with or without DM. Although three ocular surface parameters were worse in group 1 than in group 2, these differences were not significant. CONCLUSION: Adding preoperative and postoperative bromfenac 0.1% or ketorolac 0.45% to topical steroid can reduce intraoperative miosis, postoperative inflammation, and macular changes more effectively than postoperative steroid alone.
Aged ; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/pharmacology ; Benzophenones/*administration & dosage/pharmacology ; Bromobenzenes/*administration & dosage/pharmacology ; *Cataract ; *Cataract Extraction ; Female ; Humans ; Inflammation/prevention & control ; Ketorolac/*administration & dosage/pharmacology ; Lens Implantation, Intraocular ; Macular Edema/*prevention & control ; Male ; Middle Aged ; Miosis/*prevention & control ; Phacoemulsification ; Postoperative Complications/drug therapy ; Postoperative Period ; Premedication ; Treatment Outcome