Topical Nepafenac 0.1% for Macular Edema Prevention after Cataract Surgery: A Triple-Blinded RCT

Abstract

Introduction: Cystoid macular edema (CME) is a common postoperative complication following uncomplicated cataract surgery, significantly impacting visual outcomes. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) like nepafenac have shown promise in mitigating this condition.

Objective: This study assesses the effect of topical nepafenac 0.1% eye drops compared to a placebo in preventing macular edema post-cataract surgery.The primary objective is to assess the effect of topical administration of nepafenac 0.1% eye drops in patients undergoing uncomplicated cataract surgery to prevent the occurrence of macular oedema(ME).

Methodology: A randomized, triple-blind, placebo-controlled study was conducted with 72 patients undergoing uncomplicated cataract surgery. Patients were divided into two groups: Group A received nepafenac 0.1%, and Group B received a placebo. Preoperative, intraoperative, and postoperative data, including Central Macular Thickness(CMT) and best-corrected visual acuity (BCVA), were collected and analyzed at 1st, 3rd, and 6th weeks.

Result: A significant reduction in mean CMT was observed in Group A compared to Group B. At six weeks postoperatively, Group A exhibited a lower mean CMT (p < 0.01) and improved BCVA (p < 0.05). Gender and age did not significantly affect outcomes. The nepafenac-treated group showed an earlier resolution of CMT by the sixth week compared to the placebo group.

Conclusion: Topical postoperative administration of nepafenac 0.1% effectively reduces the incidence of CME and improves visual recovery in patients undergoing uncomplicated cataract surgery. Initiating nepafenac treatment postoperatively and continuing for 6 weeks postoperatively is recommended for optimal management of postoperative inflammation and CMT. This study supports the use of nepafenac as a preventive measure against CME, ensuring better postoperative visual outcomes.