Corneal thickness and anterior chamber flare after cataract surgery: A randomized controlled trial comparing five regimens for anti-inflammatory prophylaxis
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Corneal thickness and anterior chamber flare after cataract surgery : A randomized controlled trial comparing five regimens for anti-inflammatory prophylaxis. / Hansen, Niklas Cyril; Erichsen, Jesper Høiberg; Holm, Lars Morten; Kessel, Line.
In: Clinical Ophthalmology, Vol. 15, 2021, p. 2835-2845.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Corneal thickness and anterior chamber flare after cataract surgery
T2 - A randomized controlled trial comparing five regimens for anti-inflammatory prophylaxis
AU - Hansen, Niklas Cyril
AU - Erichsen, Jesper Høiberg
AU - Holm, Lars Morten
AU - Kessel, Line
N1 - Publisher Copyright: © 2021 Hansen et al.
PY - 2021
Y1 - 2021
N2 - Purpose: To investigate the relationship between early post-operative anterior chamber inflammation (aqueous flare) and central corneal thickness (CCT) after cataract surgery and to evaluate the effect of anti-inflammatory prophylaxis on CCT. Setting: Department of Ophthalmology, Rigshospitalet-Glostrup, University Hospital Copenhagen, Denmark. Design: Post-hoc analysis of a prospective randomized controlled trial. Patients and Methods: A total of 470 participants who underwent standard cataract surgery were randomly allocated to prophylactic treatment with nonsteroidal anti-inflammatory drug (NSAID, groups C and D) or a combination of NSAID and steroid eye drops (groups A and B), commenced either pre-operatively (A and C) or post-operatively on the day of surgery (B and D), or “drop-less surgery” (peri-operative subtenon depot of dexamethasone, group E). Aqueous flare was measured before and three days after surgery. CCT was measured before surgery, three days, three weeks, and three months after surgery. Data were analyzed according to the intention-to-treat method. Results: Doubling of aqueous flare increased mean CCT by 15.6 microns (95% CI 9.8; 21.3, P<0.001) three days after surgery. Mean CCT increased from 549 microns (95% CI 545; 552) at baseline to 594 microns (95% CI 585; 602) three days after surgery and returned to 551 microns (95% CI 545; 557) three months after surgery. Mean CCT was thinner in group C compared to group A three days after surgery. No difference was found for any other groups or time points. Conclusion: Increased anterior chamber inflammation was associated with significant corneal thickening three days after cataract surgery. Choice of anti-inflammatory regimen seemed to be of no or minimal importance on CCT when the effect of inflammation was accounted for. Corneal thickening is possibly mediated by underlying deterioration of the blood-aqueous barrier and corneal endothelium pump function caused by a post-operative inflammatory response.
AB - Purpose: To investigate the relationship between early post-operative anterior chamber inflammation (aqueous flare) and central corneal thickness (CCT) after cataract surgery and to evaluate the effect of anti-inflammatory prophylaxis on CCT. Setting: Department of Ophthalmology, Rigshospitalet-Glostrup, University Hospital Copenhagen, Denmark. Design: Post-hoc analysis of a prospective randomized controlled trial. Patients and Methods: A total of 470 participants who underwent standard cataract surgery were randomly allocated to prophylactic treatment with nonsteroidal anti-inflammatory drug (NSAID, groups C and D) or a combination of NSAID and steroid eye drops (groups A and B), commenced either pre-operatively (A and C) or post-operatively on the day of surgery (B and D), or “drop-less surgery” (peri-operative subtenon depot of dexamethasone, group E). Aqueous flare was measured before and three days after surgery. CCT was measured before surgery, three days, three weeks, and three months after surgery. Data were analyzed according to the intention-to-treat method. Results: Doubling of aqueous flare increased mean CCT by 15.6 microns (95% CI 9.8; 21.3, P<0.001) three days after surgery. Mean CCT increased from 549 microns (95% CI 545; 552) at baseline to 594 microns (95% CI 585; 602) three days after surgery and returned to 551 microns (95% CI 545; 557) three months after surgery. Mean CCT was thinner in group C compared to group A three days after surgery. No difference was found for any other groups or time points. Conclusion: Increased anterior chamber inflammation was associated with significant corneal thickening three days after cataract surgery. Choice of anti-inflammatory regimen seemed to be of no or minimal importance on CCT when the effect of inflammation was accounted for. Corneal thickening is possibly mediated by underlying deterioration of the blood-aqueous barrier and corneal endothelium pump function caused by a post-operative inflammatory response.
KW - Anterior chamber inflammation
KW - Cataract surgery
KW - Central corneal thickness
KW - NSAID
U2 - 10.2147/OPTH.S312350
DO - 10.2147/OPTH.S312350
M3 - Journal article
C2 - 34234406
AN - SCOPUS:85109406310
VL - 15
SP - 2835
EP - 2845
JO - Clinical Ophthalmology (Online)
JF - Clinical Ophthalmology (Online)
SN - 1177-5483
ER -
ID: 274618521