ESCRS - PP21.12 - The Effect Of Topical Nepafenac And Oral Acetazolamide For Postoperative Macular Edema After Uncomplicated Phacoemulsification

The Effect Of Topical Nepafenac And Oral Acetazolamide For Postoperative Macular Edema After Uncomplicated Phacoemulsification

Published 2026 - 44th Congress of the ESCRS

Reference: PP21.12 | Type: Poster | DOI: 10.82333/fe3k-kw59

Authors: A/Prof. Tatjana Sarenac Vulovic* 1 , Dr Dusan Todorovic 1 , Dr Katarina Cupic 1 , Dr Jovana Srejovic 1 , Dr Dusica Ostojic 2

1Department of ophthalmology,Faculty of medical sciences, University of Kragujevac,Kragujevac,Serbia, 2Clinic of ophthalmology,University Clinical Centre Kragujevac,Kragujevac,Serbia

Purpose

To estimate the effect of nepafenac combined with oral acetazolamide for postoperative macular edema (PME) after uncomplicated phacoemulsification (PE) and identify predictors of non-response. 

Setting

Clinic of ophthalmology, University Clinical Centre Kragujevac, Serbia, from the January 1st 2025. Till December 31st 2025

Methods

We included and analyzed 1000 patients, who had uncomplicated phaco surgery in Clinic of ophthalmology, University Clinical Centre Kragujevac, Serbia, from the January 1st 2025. Till December 31st 2025. All the surgeries were done by one experienced  phaco surgeon. Every examiners passed the five checking points of CFT (central macular thicknes) and BCVA (best corrected visual acuity): preoperative, the day after surgery, after 6, 12, and 18 weeks.  If the PME was estimated, the first line therapy was topical nepafenac combined with oral acetazolamide. In the case of non-response, triamcinolone was administered subtenonally or, at the end, intravitreal. 

Results

92 eyes out of 1000 uncomplicated PE developed PME, of which 15 eyes were included. Follow-ups occurred 6.8 ± 1.2, 12.1 ± 4.7 and 18.2 ± 4.8 weeks after diagnosis. BCVA and CMT improved significantly in all follow-ups. Good therapy response were recorded after first line therapy in 11 eyes at the first follow-up. The remaining 4 eyes showed no response and required subtenon triamcinolone of which 3 eye showed complete regression at the third follow-up. Only one patient required required intravitreal injection after third follow up . Using recorded data, the main risk comorbidity was Diabetes mellitus (DM). High cumulative dissipated energy (CDE) is also in statistically significant correlation with therapeutic non-response. 

Conclusions

Topical applicated nepafenac in combination with oral administred acetazolamide resolved PME completely in 73.3% of all cases. Non resopnder patients were those with DM and with high cumulative dissipated energy during surgery.