Efficacy of COX-2 inhibitors in controlling inflammation and capsular opacification after phacoemulsification cataract removal.

OBJECTIVE: To evaluate the efficacy of 0.9% bromfenac (Xibrom™) or a celecoxib-impregnated intraocular lens (celecoxib-IOL) compared with 1% prednisolone acetate (PA) in controlling postoperative inflammation and posterior capsule opacification (PCO). ANIMAL STUDIED: Fifty-nine dogs undergoing cataract extraction by phacoemulsification. PROCEDURE: Bilateral patients received bromfenac or celecoxib-IOL plus PA in one eye, and PA in the contralateral eye. Unilateral patients received bromfenac or PA. Complete ophthalmic examination including tonometry, slit-lamp grading of flare and PCO, and digital image acquisition for masked PCO evaluation was performed within 24 h and 1, 4, 12, 24, and 56 weeks following surgery. RESULTS: Celecoxib-IOL/PA-treated eyes had significantly less flare than PA-treated eyes, which had significantly less flare than bromfenac-treated eyes 24 h postoperatively. There was no significant difference in intraocular pressure (IOP) postoperatively, or at 1, 24, or 56 weeks. Celecoxib-IOL/PA-treated eyes had significantly lower IOP measurements than bromfenac and PA-treated eyes at 4 and 12 weeks. There was no significant difference in PCO level between groups using slit-lamp biomicroscopy at any time point. Masked evaluation of digital images revealed significantly less PCO in celecoxib-IOL/PA- vs. bromfenac-treated eyes at 4 weeks, and in bromfenac- vs. PA-treated eyes at 56 weeks. CONCLUSIONS: Eyes receiving celecoxib-IOL/PA had better initial control of inflammation. Bromfenac was equally effective compared with PA in controlling inflammation. There was no association between COX-2 inhibitor administration and ocular hypertension. Celecoxib-IOL/PA-treated eyes showed better initial control of PCO (up to 12 weeks), while eyes receiving bromfenac had better long-term control of PCO (56 weeks).

Comparison of capsular opacification and refractive status after placement of three different intraocular lens implants following phacoemulsification and aspiration of cataracts in dogs.

OBJECTIVE: To evaluate the effect of lens design and biomaterial on formation of posterior capsular opacification (PCO) and refractive correction. Animals studied Sixty dogs undergoing bilateral phacoemulsification for mature or diabetic cataracts. PROCEDURES: One randomly selected eye received a rounded edge 41D polymethyl-methacrylate (PMMA) intraocular replacement lens (IOL) and the contralateral eye received either a squared edge 41D hydrophilic acrylic IOL (n = 35) or a squared edge 40D hydrophobic acrylic IOL (n = 25). At the (mean = 79 day) reexamination period, PCO was graded using direct slit-lamp observation and by masked observer evaluation of digital images of the IOLs. Streak retinoscopy and B-mode ultrasound were performed at this period. RESULTS: The PCO score via direct slit-lamp was significantly lower for the hydrophilic acrylic IOL when compared to the PMMA IOL. Masked observer evaluation of digital images revealed that the acrylic IOLs had lower but generally not statistically significant PCO scores than the PMMA IOLs. Streak retinoscopy showed that the PMMA IOL was significantly closer to emmetropia (+0.44 D) when compared to either the hydrophilic acrylic (+0.96 D) or the hydrophobic acrylic (+1.2 D) IOLs. B-mode ultrasonography revealed the center of the hydrophilic acrylic IOL is 0.31 mm closer to the retina and the center of the hydrophobic acrylic IOL is 0.63 mm further from the retina when compared to the center of the PMMA to retina distance. CONCLUSIONS: Square edged foldable acrylic IOLs show a predisposition towards generating slightly less PCO than round edged PMMA IOLs in the early postoperative period, however, both acrylic IOLs had greater persistent hyperopia than the PMMA IOLs.