The effects of non-prostaglandin hypotensive drops with preservative on central retinal thickness after phacoemulsification

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Abstract

BACKGROUND: Primary open angle glaucoma is often associated with cataract. The correlation between the use hypotensive drops, in particular non-prostaglandin hypotensive drops with preservative, and the change in central retinal thickness after phacoemulsification with intraocular lens implantation continues to be relevant.

AIM: To evaluate central retinal thickness and pseudophakic cystoid macular edema incidence after phacoemulsification with intraocular lens implantation in patients with primary open-angle glaucoma using non-prostaglandin hypotensive drops with preservatives.

MATERIALS AND METHODS: 94 patients (108 eyes) with cataract were enrolled in the study, divided into 3 groups: the first group — 21 patients (27 eyes), and the second group — 21 patients (23 eyes) with primary open-angle glaucoma using non-prostaglandin hypotensive drops with preservative; the third (control) group included 52 patients (58 eyes) without ocular comorbidities. All patients underwent uncomplicated phacoemulsification with intraocular lens implantation. In the post-op period, patients of the first group received topical antibiotics and steroids, patients of the second and the third groups received the same treatment and non-steroidal anti-inflammatory drops as well. Central retinal thickness was measured using optical coherence tomography before surgery, 2 weeks, 2 and 6 months after surgery.

RESULTS: The central retinal thickness increase in comparison with baseline values was more significant in the first group than in the second and the third groups, and the time of recovery to baseline values during 6 months after surgery was longer. Pseudophakic cystoid macular edema was not identified in any group.

CONCLUSIONS: The use non-prostaglandin drops with preservative in patients with primary open-angle glaucoma does not affect pseudophakic cystoid macular edema development after uncomplicated phacoemulsification. Instillations of non-steroidal anti-inflammatory drops in the post-op period reduce the time of central retinal thickness recovery to baseline value.

About the authors

Xiaoyuan Wang

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: wangxiaoyuan20121017@gmail.com
ORCID iD: 0000-0002-1135-6796

postgraduate student of Department of Ophthalmology with Clinic

Russian Federation, Saint Petersburg

Sergey Yu. Astakhov

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: astakhov73@mail.ru
ORCID iD: 0000-0003-0777-4861
SPIN-code: 7732-1150
Scopus Author ID: 56660518500

MD, Dr. Sci. (Med.), professor, head of Department of Ophthalmology with Clinic

Russian Federation, Saint Petersburg

Anna S. Cherkashina

City Multidisciplinary Hospital No. 2

Author for correspondence.
Email: annaa.cherkashina@mail.ru
ORCID iD: 0009-0006-3837-7382

ophthalmologist in 5th Microsurgical Ophthalmology Department

Russian Federation, Saint Petersburg

Liliia K. Anikina

Academician I.P. Pavlov First St. Petersburg State Medical University; City Multidisciplinary Hospital No. 2

Email: lily-sai@yandex.ru
ORCID iD: 0000-0001-8794-0457
SPIN-code: 3359-4587

postgraduate student of Department of Ophthalmology with Clinic; ophthalmologist in Microsurgical (laser) Department

Russian Federation, Saint Petersburg; Saint Petersburg

Tat’yana R. Parasun’ko

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: exclamation@bk.ru
ORCID iD: 0000-0003-4533-7590
SPIN-code: 4362-6730

medical resident of Department of Ophthalmology with Clinic

Russian Federation, Saint Petersburg

Vitaliy V. Potemkin

Academician I.P. Pavlov First St. Petersburg State Medical University; City Multidisciplinary Hospital No. 2

Email: potem@inbox.ru
ORCID iD: 0000-0001-7807-9036
SPIN-code: 3132-9163

Cand. Sci. (Med.), assistant professor of Department of Ophthalmology with Clinic; head of 5th Microsurgical Ophthalmology Department

Russian Federation, Saint Petersburg; Saint Petersburg

Albina R. Potemkina

City Multidisciplinary Hospital No. 2

Email: prinzabiyka@mail.ru

ophthalmologist in Microsurgical (laser) Department

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. The pathogenesis of “pseudophakic preservative maculopathy” by K. Miyake [35]

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3. Fig. 2. Analysis of medications used in the first group (non-prostaglandin hypotensive drops with preservative)

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4. Fig. 3. Analysis of medications used in the second group (non-prostaglandin hypotensive drops with preservative + nonsteroidal anti-inflammatory drops)

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5. Fig. 4. Dynamics of the central retinal thickness change in studied groups

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6. Fig. 5. Dynamics of the central retinal thickness change in studied groups compared to preoperative values at different observation periods

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