Macular Alteration of Topical Diclofenac Sodium after Phacoemulsification Surgery in Diabetic Patients

Delfi Delfi; Vanda Virgayanti; Julham Alandy

doi:10.3889/oamjms.2021.6287

Authors

Delfi Delfi Department of Ophthalmology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-7973-2591
Vanda Virgayanti Department of Ophthalmology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Julham Alandy Department of Ophthalmology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6287

Keywords:

Diclofenac sodium, Phacoemulsification, Macular thickness

Abstract

BACKGROUND: Cystoid macular edema (CME) is a serious complication of cataract surgery in a diabetic patient. CME was found 1–19% after phacoemulsification surgery. Nonsteroidal anti-inflammatory drugs inhibit cyclooxygenase-1, cyclooxygenase-2, and endoperoxides. Inhibition of these enzymes also reduces macular thickening.

AIM: The aim of the study was to assess macular thickness alteration after application of 1.00 mg diclofenac sodium eye drops in diabetic patients who receive phacoemulsification surgery.

METHODS: This study was a quasi-experimental study. A total of 40 eyes diabetic retinopathy patients having phacoemulsification surgery were randomized to 100 mg diclofenac sodium (n = 20) or placebo eye drops (n = 20), three drops daily on 1 day before surgery until 30 days post-operative. The main outcome measures macular thickness using Ocular Coherence Tomography before and after (14 and 30 days) phacoemulsification.

RESULTS: Utilizing an independent t-test, this study had significantly inner macular (p = 0.0001) and central macular (p = 0.008) thickness differences in the diclofenac sodium group during surgery until 14 days postoperatively. However, significant changes in the outer macular thickness were absent. There were no notable alterations in the center, inner, and outer macular thickness in the diclofenac sodium group until 30 days postoperatively. In the placebo group, no significant changes were found in the macular thickness at every point of time.

CONCLUSION: Two statistically significant central and inner macular thicknesses in the diclofenac sodium group until 14 days postoperatively were present. There were no significant changes in the center, inner, and outer macular thickness in the diclofenac sodium group until 30 days postoperatively.

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