Efficacy of a one-week course of topical bromfenac combined with corticosteroid for prevention of pseudophakic cystoid macular edema (PCME).

PURPOSE: To compare the efficacy of a 1-week postoperative regimen of topical bromfenac combined with corticosteroid versus corticosteroid monotherapy in preventing pseudophakic cystoid macular edema (PCME).

METHODS

This retrospective study included 226 eyes of 226 patients who underwent uneventful phacoemulsification. Patients were divided into Group A (n = 158), receiving topical bromfenac 0.1% twice daily (BID) plus prednisolone acetate 1% (PDE) 6 times daily (6/d) or every 2 hours while awake (q2hrs), and Group B (n = 68), receiving PDE alone 6/d or q2hrs for the first postoperative week. Macular thickness was measured by Spectral-domain optical coherence tomography (SD-OCT) preoperatively and at postoperative week 5. PCME was defined as an increase in central subfield macular thickness (CSMT) with foveal cystoid changes. CSMT changes and PCME incidence were compared. A subgroup analysis evaluated the effect of PDE dosing frequency within the combination arm (6/d vs. q2hrs).

RESULTS

Postoperative absolute and relative CSMT changes were significantly smaller in Group A (13.3 ± 13.0 μm, 5.6 ± 5.3%) than in Group B (27.0 ± 33.7 μm, 11.2 ± 14.3%; p = 0.002). The incidence of OCT-defined PCME was lower in Group A than in Group B (5.1% vs. 16.2%; OR = 0.28; 95% CI 0.11-0.72; p = 0.006). Among eyes developing PCME, the median CSMT increase was lower in Group A (38.5 μm) than in Group B (80.0 μm; p = 0.031). PCME incidence was numerically lower in [Bromfenac BID + PDE q2hrs] subgroup than [Bromfenac BID + PDE 6/d] subgroup (2.0% vs. 10.0%, OR = 0.19; 95% CI 0.04-0.79; p = 0.054).

CONCLUSION

A one-week course of topical bromfenac combined with topical corticosteroid therapy was associated with smaller postoperative increases in macular thickness and a lower incidence of OCT-defined PCME than corticosteroid monotherapy after cataract surgery.