مقايسه قطره ديكلوفناك سديم با قطره بتامتازون در پيشگيري از ادم سيستوييدماكولا، پس از جراحي كاتاراتخت به روش خارج كپسولي با لنزگذاري

Comparison of sodium diclofenac and betamethasone eye drop in preventing cystoid macular edema after extra capsular cataract surgery

Background and purpose: Since Cystoid Macular Edema (CME) is caused by ocular inflammation after cataract surgery. Itʹs control with suitable medication is reasonable. Aim of this study was to compare a nonsteroidal topical solution (0.1 % diclofenac) to a steroidal topical solution (0.1 % betamethasone) in preventing CME after extra capsular cataract surgery. Materials and methods: A prospective randomised double blind clinical trial was performed on patients undergoing extra capsular cataract surgery with posterior chamber lens implantation. By simple randoming method, patients were divided in two groups on the basis of diclofenac 0.1 % and betamethasone 0.1 % . All patients had similar condition of ocular background (cataract) surgical procedures and inter ocular implantation in two groups. The presence and degree of CME were determined by fluorescin angiography. A breakdown of the blood-aqueous barrier was determined by anterior chamber cells and flare biomicroscopy. Results : Six weeks after surgery, CME was present in 2 of 47 eyes (4.25 %) receiving diclofenac and in 12 of 50 eyes (24 %) receiving betamethasone. There was no significant difference in cellular reaction in the anterior chamber at 3 days, 1 and 6 weeks after surgery between two groups (P<0.01). The amount of flare in the anterior chamber at 3 days, I and 6 weeks after surgery was also significantly lower (P<0.001) in diclofenac group. Also extra ocular inflammation declined in diclofenac group (P<0.001). Conclusion: These finding shows that diclofenac effectively prevents CME following cataract surgery and indicating that, CME is closely related to the post surgical intra ocular inflammation, also diclofenac can effectively reduces ocular inflammation and the occurrence of CME.