RESUMEN
PURPOSE: To evaluate the comparative effects and safety of topical diclofenac sodium, fluorometholone, and dexamethasone for controlling inflammation after routine strabismus surgery. METHODS: This was a randomized clinical trial. Ninety-nine patients admitted for surgery to treat intermittent exotropia were randomly assigned to receive 1 of 3 postoperative eye drops between January 2015 and February 2016. The primary efficacy outcomes were pain and conjunctival injection. Pain score from 0 to 10 was evaluated in each patient at postoperative days 1, 2, 3, and 5, in addition to weeks 1, 2, and 4. Conjunctival injection was graded from 1 to 4 at postoperative weeks 1, 2, and 4. We also evaluated intraocular pressure (IOP), discomfort attributed to the drops, and development of any other side effects. RESULTS: Conjunctival injection grade was the lowest in the diclofenac sodium group at postoperative weeks 1 and 2 (P < 0.001 and P = 0.03). There was no significant difference in pain score among the 3 groups. Mean IOP was the highest in the dexamethasone group at postoperative weeks 1, 2, and 4 (P < 0.001, P < 0.001, and P = 0.02). Significant IOP elevation (≥10 mmHg relative to preoperative IOP) was observed in 6 patients in the dexamethasone group. There was no difference in discomfort upon administration of the drops among the 3 groups, and no other adverse events developed. CONCLUSION: Diclofenac sodium was more effective against conjunctival injection than the 2 topical corticosteroids tested, but had a similar effect on postoperative pain as them. IOP elevation developed only in the dexamethasone group.
Asunto(s)
Dexametasona/farmacología , Diclofenaco/farmacología , Fluorometolona/farmacología , Inflamación/complicaciones , Inflamación/tratamiento farmacológico , Soluciones Oftálmicas/farmacología , Estrabismo/complicaciones , Estrabismo/cirugía , Administración Tópica , Adolescente , Adulto , Niño , Dexametasona/administración & dosificación , Diclofenaco/administración & dosificación , Femenino , Fluorometolona/administración & dosificación , Humanos , Presión Intraocular/efectos de los fármacos , Masculino , Persona de Mediana Edad , Soluciones Oftálmicas/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Adulto JovenRESUMEN
BACKGROUND: The purpose of this study was to determine the clinical parameters related to metamorphopsia outcome in patients with resolved central serous chorioretinopathy (CSCR). METHODS: The charts of 36 eyes with resolved CSCR were retrospectively reviewed. We measured metamorphopsia using M-CHARTS after resolution of serous retinal detachment. We analyzed the relationship between metamorphopsia outcome and clinical parameters including age, visual acuity, chronicity of CSCR, symptom duration and several spectral-domain optical coherence tomography findings using univariate and multivariate forward logistic regression analyses. RESULTS: The M-CHARTS detected metamorphopsia in 19 eyes (52.8 %). In the univariate analysis, the eyes with metamorphopsia were, relative to those without metamorphopsia, significantly associated with a greater proportion of chronic-recurrent CSCR, initial and final irregularities of retinal pigment epithelium, longer symptom duration, thinner final thickness of central fovea and outer nuclear layer, and final disruption of external limiting membrane (ELM), photoreceptor inner and outer segment junction and cone outer segment tip line (P = 0.003, 0.037, 0.019, 0.003, 0.013, 0.015, <0.001, 0. 012 and 0.002, respectively). However, in the multivariate analysis, chronic-recurrent CSCR (OR 22.5, P = 0.019) and final disrupted ELM (OR 82.6, P = 0.004) were the independent clinical parameters related to poor metamorphopsia outcome. CONCLUSIONS: Residual metamorphopsia was detected using M-CHARTS in about half of patients (52.8 %) with resolved CSCR. Chronic-recurrent CSCR and final disrupted ELM were the independent clinical parameters related to poor metamorphopsia outcome in patients with resolved CSCR.