Do Non-Steroidal Anti-Inflammatory Drugs Delay Posterior Capsule Opacification After Phacoemulsification in Children? A Randomized, Prospective Controlled Trial

• Published in: Current eye research 2011-12, Vol.36 (12), p.1139-1147
• Main Authors: Evereklioglu, Cem, lhan, Özgür
• Format: Article
• Language: English
• Subjects: Anti-Inflammatory Agents - administration & dosage; Capsule Opacification - etiology; Capsule Opacification - pathology; Capsule Opacification - prevention & control; Cataract; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Ketorolac; Ketorolac - administration & dosage; Lenses, Intraocular; Male; Non-steroidal anti-inflammatory drug; Ophthalmic Solutions; Pediatric phacoemulsification; Phacoemulsification - adverse effects; Posterior Capsule of the Lens - drug effects; Posterior Capsule of the Lens - pathology; Posterior Capsule of the Lens - surgery; Posterior capsule opacification; Prospective Studies; Severity of Illness Index; Treatment Outcome
• ISSN: 0271-3683; 1460-2202
• DOI: 10.3109/02713683.2011.609304

Purpose: To evaluate the efficacy of topical ketorolac for the prevention of posterior capsule opacification (PCO) in pediatric cataract surgery. Materials and methods: The eyes were prospectively and randomly assigned to receive postoperative 3-month topical ketorolac 0.5% drops with intact posterior capsule (group 1) or primary posterior capsulotomy combined with anterior vitrectomy (group 2). All children had uneventful corneal small-incision phacoemulsification with a primary implantation of a foldable acrylic posterior chamber intraocular lens (IOL). The frequency and timing of severe PCO was evaluated for each group and documented by slit-lamp examination and photography. Results: A total of 38 eyes of 27 children (15 girls, 12 boys) were included in the study. Among them 16 children had unilateral and 11 had bilateral surgery. All cataracts were developmental cases diagnosed between 1 and 7 years of age. There were 20 eyes in group 1 and 18 eyes in group 2. Mean pediatric age at surgery was 38.1 months (12-72 months) in group 1 and 34.2 months in group 2 children (12-78 months) (p > 0.05). Overall mean follow up was 26.3 months (6-48 months). Clinically significant PCO that finally needed neodymium:YAG laser application developed in four eyes (20.0%) in group 1 and in two eyes (11.1%) in group 2, and the difference was not statistically significant (chi-square test, p >0.05). Conclusions: Long-term postoperative use of topical ketorolac drops with the preservation of posterior capsule was found to be effective for the prevention of PCO in pediatric cataract surgery, at least during the period of this study.