Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac

Figures & data

Figure 1 Mechanism of action of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

Table 1 Patients’ demographic and pre-operative systemic and ocular pathology

Parameter	Group		*p
	Control (N = 30)	Nepafenac (N = 30)
Age in years			0.561
Mean ± SD	71.2 ± 8.8	72.6 ± 10.5
Range	51 to 85	52 to 88
Gender, N (%)			0.601
Male	12 (40)	10 (33.3)
Female	18 (60)	20 (66.6)
Eye, N (%)			0.838
Right eye	14 (46.6)	15 (50)
Left eye	16 (53.3)	15 (50)
Ocular and systemic pathology, N
DM	7	5	0.572
Without DR	3	3	1.000
With DR	4	2	0.423
Hypertension	7	10	0.477
Heart disease	4	3	0.662

* Student’s t test.

Abbreviations: SD, standard deviation; DM, diabetes mellitus; DR, diabetic retinopathy.

Figure 2 Comparison of horizontal pupil size in the nepafenac and control groups during surgery.

Table 2 Mean horizontal diameter of the pupil during the different stages of cataract surgery

Surgery stages	Group		*p
	Control (mm)	Nepafenac (mm)
Before surgery	8.44 ± 0.59	8.70 ± 0.75	0.143
After nuclear emulsification	7.60 ± 0.84	8.17 ± 0.72	0.007
Following cortex aspiration	7.14 ± 0.87	8.13 ± 0.74	<0.001
Conclusion of surgery	6.84 ± 0.93	7.91 ± 0.74	<0.001
Total loss of mydriasisa	1.59 ± 0.94	0.78 ± 0.56	<0.001
Percent total loss	18.91	9.03	<0.001

* ANOVA;

^a Difference between pupil diameter before surgery and pupil diameter at the conclusion of surgery.

Table 3 Decrease in pupil diameter (failure to maintain mydriasis) at the end of surgery and its relative risk

	Group		*p
	Control	Nepafenac
Loss of ≥1.5 mm, N (%)	17 (85)	3 (15)	<0.001
Relative risk	5.7	0.18

* Fisher’s Exact test.

Table 4 Average foveal thickness (FT) and total macular volume (TMV) in the control and nepafenac groups

Parameters	Time point	Group		*p
		Control	Nepafenac
FT, microns ± SD	Baseline	196.03 ± 18.32	192.60 ± 21.33	0.506
	2 weeks	203.46 ± 19.40	195.30 ± 19.66	0.111
	6 weeks	203.86 ± 17.98	194.43 ± 20.26	0.062
TMV, mm^3 ± SD	Baseline	6.79 ± 0.189	6.65 ± 0.354	0.056
	2 weeks	7.03 ± 0.212	6.68 ± 0.446	<0.001
	6 weeks	7.07 ± 0.242	6.69 ± 0.436	<0.001

* ANOVA; p value represents the difference between the control and the nepafenac groups.

Abbreviations: SD, standard deviation; FT, foveal thickness; TMV, total macular volume.

Table 5 Differences in total macular volume (TMV) from baseline 2 and 6 weeks after surgery

Time point	Group		*p
	Control (mm^3 ± SD)	Nepafenac (mm^3 ± SD)
2 weeks	0.241 ± 0.115	0.031 ± 0.224	<0.001
6 weeks	0.277 ± 0.243	0.038 ± 0.242	<0.001

* ANOVA.

Abbreviations: TMV, total macular volume; SD, standard deviation.

Table 6 Differences in total macular volume (TMV) from baseline 2 and 6 weeks after surgery in the presence and absence of diabetes mellitus

Group	Time point	Diabetes mellitus		*p
		Present (N = 7)	Absent (N = 23)
Control (mm^3 ± SD)	2 weeks	0.251 ± 0.125	0.205 ± 0.064	0.181
	6 weeks	0.294 ± 0.267	0.221 ± 0.140	0.288
		Present (N = 5)	Absent (N = 25)
Nepafenac (mm^3 ± SD)	2 weeks	0.04 ± 0.202	0.031 ± 0.232	0.464
	6 weeks	0.096 ± 0.264	0.026 ± 0.242	0.283

* Student’s t test.

Abbreviation: TMV, total macular volume.