Diclofenac better than fluorometholone for preventing postop CME in pseudophakic eyes

Topical diclofenac appears to be more effective than fluorometholone for preventing the reduction in choroidal blood flow, disruption of the blood-aqueous barrier and development of cystoid macular edema that can occur in pseudophakic eyes during the early postoperative period, according to a study by researchers in Japan.

Kensaku Miyake, MD, and colleagues randomly assigned 50 patients to 5 weeks of daily treatment with either topical diclofenac or topical fluorometholone after undergoing phacoemulsification and foldable IOL implantation. They compared these patients with a control group of 20 patients who had long-standing pseudophakia.

Investigators found that patients who received fluorometholone had significantly reduced choroidal blood volume at 2 weeks follow-up (P = .022) and significantly reduced choroidal blood flow at 1 week (P = .003) and 2 weeks (P = .000) weeks after surgery.

Fluorometholone-treated patients also showed significantly more anterior flare at 1 week (P = .001) and 2 weeks (P = .025) follow-up, according to the study.

At 5 weeks follow-up, both choroidal blood volume and flow returned to normal in the fluorometholone-treated group and were similar to patients who received diclofenac, the authors noted.

However, the incidence of fluorescein angiographic CME trended to be higher (P = .08) at 2 weeks and was significantly higher (P = .001) at 5 weeks after surgery in eyes with fluorometholone than with diclofenac, they said.

The study is published in the December issue of Investigative Ophthalmology & Visual Science.