Effect of postoperative administration of nonsteroidal antiinflammatory drugs and steroids on the conformational changes in wound healing after cataract surgery

Abstract

PURPOSE: To assess the changes in clear corneal incision (CCI) healing resulting from the postoperative administration of nonsteroidal antiinflammatory drugs (NSAIDs) or steroids using anterior segment optical coherence tomography (AS-OCT).

SETTING: Institute of Vision Research, Department of Ophthalmology, Yonsei University, Seoul, South Korea.

DESIGN: Prospective randomized comparative study.

METHODS: Eyes having cataract surgery were randomly given an NSAID (bromfenac 0.1% [Bronuck]) or a steroid (prednisolone acetate 1.0% [Pred Forte]). Using AS-OCT, structural changes of CCIs were examined 1 day and 1, 3.5, and 23 weeks postoperatively. The incidence and size of 5 wound deformities (endothelial gape, Descemet membrane detachment, epithelial detachment or defect, posterior misalignment, loss of coaptation) were analyzed. The correlation between the mean total wound deformity scores (wound instability) and surgically induced astigmatism (SIA) was evaluated.

RESULTS: The bromfenac group comprised 29 eyes and the prednisolone group, 30 eyes. During the 6-month follow-up, the overall changes in wound instability were not significantly different between groups, although epithelial detachment or a larger defect was more frequent in the bromfenac group between 1 week and 3.5 weeks postoperatively. The SIA at 1 week was positively correlated with wound instability and wound instability at 1 day was positively correlated with cataract grading in both groups.

CONCLUSIONS: No significant difference in the conformational changes of cataract wounds (aside from increased epithelial detachment or defect in bromfenac group) was observed between NSAIDs and steroids administered postoperatively. In the early postoperative period, high wound instability was associated with SIA, possibly contributing to worse visual outcomes.INANCIAL DISCLOSURE:

None of the authors has a financial or proprietary interest in any material or method mentioned.