Effects of Topical Nepafenac and Fluorometholone on Macular Thickness After Posterior Capsulotomy Using Neodymium-doped Yttrium-Aluminum-Garnet Laser

INTRODUCTION: The aim of this study was to assess the effects of topical 0.1% nepafenac and 0.1% fluorometholone on macular thickness (MT) after a neodymium: yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy and to compare the findings with those of untreated patients.
METHODS: This prospective study included 75 eyes of 75 patients with posterior capsule opacification. The patients were divided into 3 groups according to the medications administered after a capsulotomy procedure. Group 1 comprised 25 patients who were prescribed 0.1% nepafenac for a week, Group 2 consisted of 25 patients who were prescribed 0.1% fluorometholone for a week, and Group 3 consisted of 25 patients who were not prescribed any medication. A circular-shaped capsulotomy was performed in all cases. MT was measured before the capsulotomy and at the first day, first week, and first month after the procedure using spectral domain-optical coherence tomography and the change values were compared within and between groups.
RESULTS: In Group 1, the superior and nasal parafoveal MT, temporal, and nasal perifoveal MT values at the first month were statistically significantly greater than those observed in the first week (p<0.05 for all values). In Group 2, the superior and nasal parafoveal MT and inferior perifoveal MT measurements in the first month were greater than those recorded the first week (p<0.05 for all values). In Group 3, there was a gradual increase seen in the first day, first week, and first month in the superior and temporal parafoveal MT value (p<0.05 for all). The change value in the parafoveal temporal quadrant was significant between groups, indicating a greater increase in the untreated group compared with the nepafenac and fluorometholone groups (p=0.04).
DISCUSSION AND CONCLUSION: An increase in MT can occur after an Nd: YAG laser posterior capsulotomy. Both topical 0.1% nepafenac and 0.1% fluorometholone can prevent this increase. The 2 drugs were comparable; neither demonstrated apparent superiority to the other.