A prospective randomized clinical trial comparing nepafenac, intravitreal triamcinolone and no adjuvant therapy for epiretinal membrane. Issue 1 (12th April 2021)

• Record Type: Journal Article
• Authors: Mandelcorn, Efrem D.; Al‐Falah, Mohammed; Zhao, Lei Di; Kertes, Peter; Devenyi, Robert; Lam, Wai‐Ching
• Is Part Of: Acta ophthalmologica. Volume 100:Issue 1(2022)
• Page Start: e297
• Page End: e303
• Publication Date: 2021-04-12
• Subjects: epiretinal membrane -- macular oedema -- triamcinolone acetonide -- nepafenac -- randomized controlled trial -- pars plana vitrectomy; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.14873
• Languages: English
• ISSNs: 1755-375X

Abstract

Abstract: Purpose: To compare the efficacy of topical nepafenac 0.1% versus intravitreal triamcinolone acetonide (IVTA) at the conclusion of vitrectomy surgery versus no adjuvant therapy (NAT) in improving macular morphology post‐operatively in patients undergoing vitrectomy for epiretinal membrane (ERM), as measured by optical coherence tomography (OCT) imaging and best‐corrected visual acuity (BCVA). Methods: Design: Prospective randomized clinical trial Setting: Multi‐centre 80 patients scheduled to undergo vitrectomy surgery for idiopathic ERM were randomized to receive either IVTA (4 mg/0.1 cc) at the end of surgery, topical nepafenac sodium 0.1% TID for 1 month post‐operation or no adjuvant treatment (NAT). Optical coherence tomography (OCT) imaging, best‐corrected visual acuity and intraocular pressure (IOP) were measured before surgery, and 1 and 2 months post‐operation. Results: Although all three groups showed reduction in macular thickness post‐operation, the NAT group showed the most improvement, with a reduction of 136.18 ± 29.84 μm at two months. There was no statistically significant difference in macular thickness between the groups at each time point, p = 0.158. The NAT group also had the best recovery in BCVA with an improvement of 0.207 logMAR (10.35 letters) at two months post‐operation. There was no statistically significant difference in BCVA between the groups, p = 0.606. There was statistically significant difference in the IOP between the three groups, p = 0.04 only at 1‐month visit. The IVTA group had the highest rise in average IOP at both 1 and 2 months post‐operation (2.72 and 1.58 mmHg, respectively). Conclusion: Our study data suggest there was no advantage in the use of topical nepafenac or IVTA for post‐vitrectomy ERM surgery.