First Author: M.Karliychuk UKRAINE
Co Author(s): S. Pinchuk A. Urazov O. Baryska
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To assess the efficacy of topical application of Nepafenac 0.1% ophthalmic solution in the pre- and postsurgical treatment of vitreomacular traction syndrome (VMT).
Bukovinian State Medical University, centre of Modern Ophthalmology “Vash Zir”, Chernivtsi, Ukraine.
The medical charts of 37 patients (37 eyes) with symptomatic VMT without macular hole who underwent 23-gauge transconjunctival sutureless pars plana vitrectomy with removal of vitreomacular traction, epiretinal membrane and internal limiting membrane peeling were reviewed. 20 patients (20 eyes) of main group additionally received instillation of 0.1% Nepafenac ophthalmic solution 2 times a day during 1 month before and 1 month after surgery. The efficacy criteria were visual acuity changes and mean central macular thickness. Ophthalmic examination including visual acuity testing, fundus examination with a 3-mirror Goldman lens, and mean macular thickness measurement by optical coherence tomography (RTVue-100, Optovue, USA) was performed at baseline, at 1 and 3 months after surgical treatment.
The mean presurgical visual acuity was 0.28 ± 0.15. The mean central macular thickness was 438±78 μm at baseline, which was significantly reduced to 267±49 μm in 3 month follow-up. In 1 month after surgery normal foveal configuration with visual improvement was observed in 15 eyes of main group and 7 eyes of control group. Improvement in visual acuity was not significant between main and control group in 3-month follow-up, but in patients of main group visual acuity was remarkably higher in 1-month follow-up (0.29±0.12 to 0.8±0.17 (p<0.05), and 0.27±0.13 to 0.5±0.11 in patients of control group). Mean foveal thickness in main group decreased significantly from 454±51 μm to 224±33 μm (p<0.05), and from 443±62 μm to 288±75 μm – in control group. Cystoid macular edema was present in 2 eyes of main group and 5 eyes of control group in 1 month after surgery.
Our results suggest that medical support of surgical treatment of vitreomacular traction syndrome with nonsteroidal anti-inflammatory prodrug Nepafenac 0.1% ophthalmic solution was effective leading to significant visual acuity improvement, normalization of macular thickness in most of the patients.