The Effect of Topical Diclofenac on Choroidal Blood Flow in Early Postoperative Pseudophakias with Regard to Cystoid Macular Edema Formation

DOI Web Site PubMed 被引用文献2件 オープンアクセス
  • Kensaku Miyake
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the
  • Kazuo Nishimura
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the
  • Seiyo Harino
    Yodogawa Christian Hospital, Osaka, Japan.
  • Ichiro Ota
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the
  • Sayaka Asano
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the
  • Nagako Kondo
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the
  • Sampei Miyake
    From the Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan; and the

書誌事項

公開日
2007-12-01
DOI
  • 10.1167/iovs.07-0262
公開者
Association for Research in Vision and Ophthalmology (ARVO)

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説明

To study the chronological change in choroidal blood flow (ChBFlow), disruption of the blood-aqueous barrier, and incidence of cystoid macular edema (CME) in early postoperative pseudophakic eyes, as well as the effect of nonsteroidal anti-inflammatory drug (NSAID) eye drops on these phenomena.Fifty patients who underwent phacoemulsification and foldable intraocular lens (IOL) implantation were randomized to receive either topical diclofenac or fluorometholone for 5 postoperative weeks. An additional 20 subjects, with long-standing pseudophakia served as the control. The blood-aqueous barrier was examined by laser flarimetry and choroidal blood velocity (ChBVel), volume (ChBVol), and ChBFlow by laser Doppler flowmetry (LDF) at 2 days and 1, 2, and 5 weeks after surgery. The incidence and severity of CME were evaluated by fluorescein angiography at 2 and 5 weeks after surgery.Compared with patients taking diclofenac, those receiving fluorometholone showed significantly reduced ChBVol at 2 weeks (0.38 +/- 0.08 vs. 0.32 +/- 0.07, P = 0.022) and ChBFlow at 1 (11.01 +/- 1.74 vs. 9.35 +/- 1.51, P = 0.003) and 2 (11.15 +/- 1.43 vs. 8.47 +/- 1.27, P = 0.000) weeks after surgery, as well as a significantly elevated amount of anterior flare at 1 (8.9 +/- 2.2 vs. 24.4 +/- 18.9, P = 0.001) and 2 (9.2 +/- 3.5 vs. 16.7 +/- 12.3, P = 0.025) weeks after surgery. The ChBVol and ChBFlow in the fluorometholone group, however, returned to normal and was not different from the diclofenac group at 5 weeks after surgery. The incidence of fluorescein angiographic CME trended to be higher (P = 0.08) at 2 weeks and was significantly higher (P = 0.001) at 5 weeks after surgery in eyes with fluoromethalone than with diclofenac.Reduction of ChBFlow, disruption of the blood-aqueous barrier, and incidence of CME in early postsurgical pseudophakic eyes were more effectively prevented chronologically in eyes treated with diclofenac than in those treated with fluorometholone.

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