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Choroidal and retinal thickness changes after uneventful cataract surgery in patients treated prophylactically with topical ketorolac or bromfenac

Session Details

Session Title: Imaging IV

Session Date/Time: Sunday 20/09/2015 | 11:00-13:00

Paper Time: 11:24

Venue: Thalie.

First Author: : I.Gama PORTUGAL

Co Author(s): :    L. Almeida   W. Rodrigues   I. Goncalves   R. Couceiro   M. MonteiroGrillo  

Abstract Details

PURPOSE:The aim of this study was to evaluate the changes of macular and choroidal thickness after uncomplicated cataract surgery, using enhanced depth imaging spectral domain optical coherence tomography (EDI-OCT) in eyes treated prophylactically with topical ketorolac or bromfenac.

Setting:

Department of Ophthalmology, Hospital de Santa Maria (Centro Hospitalar Lisboa Norte), Lisbon, Portugal. No financial disclosure of any of the authors.

Methods:

In 20eyes of 20patients, the macular retinal (RT) and choroidal (CT) thicknesses were measured preoperatively and at 1week and 1month after phacoemulsification using EDI-OCT Spectralis(Heidelberg). 10 eyes of 10 patients were treated prophylactically with topical ketorolac 5mg/ml and the other 10 eyes (10patients) were treated with topical bromfenac 9mg/ml. Measurements were performed at the fovea and at 750, 1500 and 2250 μm from the fovea, in the horizontal and vertical scans. The mean of results obtained in each OCT scan was calculated. The RT and CT at 1 week and 1 month after phacoemulsification were compared to the respective values in the preoperative period(PP). RT and CT changes were compared between bromfenac-treated eyes and ketorolac-treated eyes. Full ophthalmological exam was performed in each visit. Axial length, spherical equivalent and intraocular pressure were recorded.

Results:

Mean-subfoveal CT(SFCT) measured at PP,1week and 1month were 202,0±55,0μm; 267,8±78,7μm and 239,4±51,2μm,respectively. Mean central RT at PP,1 week and 1 month were 242,6±23,1μm; 262,8±32,3μm and 262,5±64,1μm,respectively. There was a statistically significant increase in SFCT at 1week(p<0,001) and 1month(p=0,008).Mean CT in horizontal scans(HS) increased to 219,9±63,0μm(p=0,002)at 1week,and to 218,8±58,5μm(p=0,001)at 1month.In vertical scans(VS), CT increased to 237,9±66,0μm(p<0,001) at 1 week, and to 226,1±62,8μm(p<0,001)at 1 month. Mean RT in VS increased slightly to 316,0±19,9μm(p=0,024) at 1 week and 312,1±22,9μm(p=0,023) at 1 month after surgery. Mean RT in HS increased slightly to 316,6±19,6μm(p=0,026) at 1 week after surgery. There were not statistical significative differences in CT and RT changes between ketorolac and bromfenac groups (p>0,05).

Conclusions:

Uncomplicated phacoemulsification can induce nonpathologic increases in choroidal thickness, even with prophylatic anti-inflammatory treatment. Choroidal thickness can be increased at 1week and 1 month after surgery. The macular retinal thickness can also increase subclinically at 1 week and 1 month after surgery, due to the inflammatory insult caused by phacoemulsification. The changes in RT and CT that occur in uncomplicated cataract surgery appear to be similiar in both ketorolac and bromfenac prophylactic anti-inflammatory treatments. The macular OCT is useful in monitoring the subclinical macular retinal and choroidal changes in thickness that can occur after cataract surgery.

Financial Disclosure:

No

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