DOI: 10.4103/ejos.ejos_17_26 ISSN: 2090-0686

Perioperative topical diclofenac sodium 0.1% versus nepafenac 0.1% versus ketorolac tromethamine 0.5% in phacoemulsification in diabetic patients

Mohamed S. Helal, Ashraf A. Nossair, Wael A. Ewais, Mohamed S. Kotb
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Purpose

To assess and compare the effect of perioperative use of topical diclofenac sodium 0.1%, nepafenac and ketorolac tromethamine 0.5% in controlling postoperative inflammation, macular edema, and in maintaining pupillary dilatation during cataract surgery in diabetic patients.

Patients and methods

Sixty eyes undergoing phacoemulsification in diabetic patients were divided into three groups who received perioperative topical diclofenac sodium 0.1%, nepafenac 0.1%, and ketorolac tromethamine 0.5%, respectively. Pupil diameter was assessed preoperatively and throughout the surgery. Patients were followed up 1, 5 days, 2, 6, and 12 weeks after surgery by recording best corected visual acuity, postoperative inflammation, and pain. Macular thickness was assessed preoperatively and 6 months after the surgery.

Results

Best corrected visual acuity was not statistically different between the study groups ( P= 0.768) 3 months after the surgery. Regarding postoperative inflammation ( P =0.260 and 0.052 at 1st and 5th postoperative day, respectively), Diclofenac group was the first to show no cells in anterior chamber. Diclofenac, nepafenac, and ketorolac were equally effective in maintaining pupillary dilatation throughout the surgery ( P =0.362, 0.486 before and at the end of the surgery, respectively). Mean percentage change in central subfield thickness was (4.01± 3.66%, 2.91± 7.36%, and −1.47± 3.35% in group A, B, and C, respectively).

Conclusion

Topical Diclofenac Sodium 0.1%, nepafenac 0.1%, and ketorolac tromethamine 0.5% are equally effective in controlling postoperative inflammation after cataract surgery in Diabetic patients with Ketorolac having the best performance in controlling cystoid macular edema.

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