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Topical NSAIDs may improve vision in IOL patients
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SAN FRANCISCO — Administering keratolac tromethamine 0.4% both preoperatively and postoperatively may improve the visual outcomes for patients who have undergone a multifocal IOL implantation, according to Eric D. Donnenfeld, MD. He presented his results here at the American Society of Cataract and Refractive Surgery meeting.
“I think over the past year or so, we have seen a revolution, with multifocal IOLs becoming increasingly popular,” said Dr. Donnenfeld. “We wanted to look at the effect topical non-steroidal anti-inflammatory drugs have on the quality of vision for people with multifocal IOLs.”
He described a multicenter prospective study to assess the effect of ketorolac tromethamine 0.4% four times daily for 3 days preoperatively and for 3 weeks postop. Results were compared with control patients; emphasis was on quality of vision. About 40 patients had been implanted bilaterally with the ReSTOR multifocal IOL (Alcon), he said.
Uncorrected visual acuity, best corrected visual acuity, mesopic and photopic contrast sensitivity were assessed at 2 weeks and 3 months after the second eye implantation. Lifestyle questionnaires given at 3 months showed the patients who were also given keratolac tromethamine had improved satisfaction with their multifocal IOLs compared to the patients who were not given the NSAID.
Dr. Donnenfeld added that using topical NSAIDs may also help prevent cystoid macular edema (CME).
“There’s a myth that CME is not common, but in fact it is common,” he said. “Preoperative and postoperative topical NSAIDs are important in patients receiving multifocal IOLs. This brings me to the point that we have really raised the bar on how we judge our outcomes. Snellen acuity is important, but quality of vision is the most important.”