ESCRS - PO285 - Perioperative Topical Nepafenac Vs Ketorolac Tromethamine Vs Diclofenac Sodium In Phacoemulsification In Diabetic Patients

Perioperative Topical Nepafenac Vs Ketorolac Tromethamine Vs Diclofenac Sodium In Phacoemulsification In Diabetic Patients

Published 2025 - 43rd Congress of the ESCRS

Reference: PO285 | Type: Free paper | DOI: 10.82333/h222-3d09

Authors: Khalid Abdulaziz Aldihan* 1 , Nayef Alotaiby 1 , Musa Alrashedi 2 , Ahmed Mousa 3 , Faisal Aldihan 2

1Glaucoma Division,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 2Fellowship and Residency Training Program,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia, 3Research Department,King Khaled Eye Specialist Hospital,Riyadh,Saudi Arabia

Purpose

To compare the effect of perioperative nepafenac vs ketorolac tromethamine vs diclofenac sodium on intraoperative pupil size and postoperative intraocular pain, inflammation and macular edema in eyes of diabetic patients undergoing phacoemulsification.

Setting

Diabetic patients undergoing phacoemulsification in Kasr Alainy University Hospital

Methods

this is a randomized clinical trial carried out on 60 patients. They were divided into three groups, Group 1: consists of 20 patients who received epifenac eye drops, Group 2: consists of 20 patients who received ketorolin eye drops, Group 3: consists of 20 patients who received nevaxal eye drops.
Primary outcome: Measurement of intraoperative pupil diameter through recording a video for each step of the operation.
Secondary outcomes: Measurement of: the change in macular thickness using OCT, postoperative ocular pain assessment using ocular pain scale, postoperative inflammation through the determination of anterior chamber cells and flare grades based on SUN classification.

Results

There were also no statistically significant differences between study groups regarding best corrected visual acuity (BCVA) whether pre-operatively (P value 0.109) or in post-operative follow up visits.

There were no statistically significant differences between study groups regarding pupil diameter pre-operatively (P value 0.362) or in post-operative follow up visits.

The study showed statistically significant difference between study groups regarding the % of thickness increase post-operatively (P value <0.001).  Ketorolin eye drops reduced the thickness increase post-operatively more than Nevaxal eye drops (P value 0.022) and more than Epifenac eye drops (P value <0.001). 

Conclusions

Ketorolac tromethamine was found to be more effective than diclofenac sodium and nepafenac in preventing the increase in macular thickness that may occur following phacoemulsification.