Comparing the Effect of Different Anti-Inflammatory Treatment Regimens on the incidence of pseudophakic cystoid Macular Edema after Uneventful Phacoemulsification Surgery

Abstract Aim: To compare the effects of different topical anti-inflammatory regimens on the incidence of macular edema after uneventful phacoemulsification surgery  Methods: Randomized clinical trial. 65 eyes with no evident risk factor of post operative CME did phacoemulsification were assigned to 3 groups according to the type of postoperative anti-inflammatory treatment regimen used, group A received postoperative topical NSAIDs with topical steroid eye drops, group B received only postoperative steroid eye drops and group C received single immediately postoperative subconjunctival injection of 0.5 mL (20 mg) triamcinolone acetonide. Patients were evaluated preoperatively, at 2 week and 6 weeks postoperatively as regard central macular thickness by OCT, decimal BCVA and IOP. Results: Changes of central macular thickness on OCT in the 3 studied periods were lower in group A than in group B and C, however they are not statistically significant. During the study, 4 patients  (6.15%) developed PCME according to cutoff value of 315 µm central macular thickness. Additionally,  correlations between central macular thickness changes and different preoperative and operative parameters including age, sex,  relevant systemic diseases, cataract density, surgeon factor and phaco machine used,  were assessed during the 6-weeks follow-up period and found to be not statistically significant. Also, there were no statistically significant differences between the 3 groups as regards  improvement of BCVA or reduction of IOP. Conclusion: A single subconjunctival triamcinolone depot injection at the end of uncomplicated cataract surgery is a safe and effective alternative to topical steroid eye drops in preventing postoperative intraocular inflammation.