Intensified Topical Steroids as Prophylaxis for Macular Edema After Posterior Lamellar Keratoplasty Combined With Cataract Surgery.
Am J Ophthalmol
; 163: 174-179.e2, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26701270
ABSTRACT
PURPOSE:
To analyze the effect of intensified topical steroid therapy after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple-DMEK) on the incidence of postoperative cystoid macular edema (CME).DESIGN:
Single-center comparative clinical study with historical controls.SETTING:
Department of Ophthalmology, University of Cologne, Germany, tertiary hospital, performing 500 corneal transplant surgeries per year. PATIENTS Total of 131 patients (150 eyes) undergoing triple-DMEK surgery. Inclusion Criterion Triple-DMEK surgery. EXCLUSION CRITERIA Prior retinal surgery, history of prior CME.INTERVENTIONS:
Prednisolone acetate eye drops 1% 5 times daily for the first week after surgery. After an internal change of therapy regimen Prednisolone acetate eye drops 1% hourly for the first postoperative week. We compared 75 consecutive eyes before with 75 consecutive eyes after the change of therapy regimen. Patients received macular spectral-domain optical coherence tomography (SD OCT) preoperatively, as well as 6 weeks and 3 and 6 months post surgery. MAIN OUTCOMEMEASURE:
Development of CME detected by macular SD OCT during 6 months postoperatively.RESULTS:
Both groups were comparable regarding baseline age, sex, central corneal thickness, rebubbling rate, and visual acuity. With topical steroid therapy 5 times per day during the first postoperative week, we observed 9 cases of subsequent CME (12%). With hourly topical steroid therapy none of the patients developed CME subsequently (P = .003). Apart from the topical steroids during the first week, medical treatment was identical in both groups.CONCLUSIONS:
Early intensified postoperative topical steroid therapy constitutes an effective prophylactic treatment to reduce incidence of CME after triple-DMEK surgery.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prednisolona
/
Edema Macular
/
Facoemulsificação
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Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
/
Glucocorticoides
Tipo de estudo:
Etiology_studies
Limite:
Adult
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Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article