Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time

Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology,...

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Autores principales:	Kohji Nishida, Takashi Shiono, Kanako Yasuda, Toru Nakazawa, Masahiko Shimura
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/52d785337a0f4703b0219f8bb5853cff
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spelling	oai:doaj.org-article:52d785337a0f4703b0219f8bb5853cff2021-12-02T05:25:19ZDiclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time1177-54671177-5483https://doaj.org/article/52d785337a0f4703b0219f8bb5853cff2008-10-01T00:00:00Zhttp://www.dovepress.com/diclofenac-prevents-temporal-increase-of-intraocular-pressure-after-un-a2505https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology, Shiono Eye Center, Sendai, JapanPurpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP) after cataract surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group.Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total). Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA) in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT) for each case was recorded.Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters.Conclusions: Postoperative increase in IOP after cataract surgery was affected by total surgery time and EPT in the betamethasone-treated eye. The time for surgery and EPT is longer in complicated cases including patients with a hard nucleus or small pupils, and also longer for beginning surgeons and in older patients. In these cases, diclofenac in place of betamethasone as a postoperative topical antiinflammatory drug is recommended for the prevention of postoperative increase in IOP.Keywords: intraocular pressure, cataracts, visual acuity, betamethasone, diclofenac Kohji NishidaTakashi ShionoKanako YasudaToru NakazawaMasahiko ShimuraDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2009, Iss default, Pp 95-101 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kohji Nishida Takashi Shiono Kanako Yasuda Toru Nakazawa Masahiko Shimura Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
description	Masahiko Shimura1, Toru Nakazawa2, Kanako Yasuda1, Takashi Shiono3, Kohji Nishida21Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan; 2Department of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Ophthalmology, Shiono Eye Center, Sendai, JapanPurpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP) after cataract surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group.Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total). Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA) in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT) for each case was recorded.Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters.Conclusions: Postoperative increase in IOP after cataract surgery was affected by total surgery time and EPT in the betamethasone-treated eye. The time for surgery and EPT is longer in complicated cases including patients with a hard nucleus or small pupils, and also longer for beginning surgeons and in older patients. In these cases, diclofenac in place of betamethasone as a postoperative topical antiinflammatory drug is recommended for the prevention of postoperative increase in IOP.Keywords: intraocular pressure, cataracts, visual acuity, betamethasone, diclofenac
format	article
author	Kohji Nishida Takashi Shiono Kanako Yasuda Toru Nakazawa Masahiko Shimura
author_facet	Kohji Nishida Takashi Shiono Kanako Yasuda Toru Nakazawa Masahiko Shimura
author_sort	Kohji Nishida
title	Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
title_short	Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
title_full	Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
title_fullStr	Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
title_full_unstemmed	Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
title_sort	diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/52d785337a0f4703b0219f8bb5853cff
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Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time

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