Purpose: To examine preoperative anti-inflammatory treatment on recovery
from cataract surgery in eyes of diabetic patients. Methods: A
Prospective randomized clinical trial. One hundred and three eyes of 103
patients with diabetes undergoing routine cataract surgery were
randomized (1:1) not to receive any preoperative anti-inflammatory
medication or to receive preoperative topical anti-inflammatory
medication with a combination of prednisolone acetate (10 mg/ml) and
nepafenac (1 mg/ml). All eyes received postoperative anti-inflammatory
combination therapy for 3 weeks. Recovery from surgery was recorded by a
structured home questionnaire. Clinical outcome parameters were
recorded at 28 days and 3 months. Results: Patient age and gender
distribution, and all baseline ophthalmic and systemic parameters were
comparable between the study groups. After surgery, conjunctival
injection lasted 2.4 ± 1.7 days (mean ± SD) and irritation of the eye
3.3 ± 3.9 days in eyes without preoperative treatment, when compared to
1.6 ± 1.6 days (p = 0.067) and 2.4 ± 4.0 days (p = 0.431), respectively,
in eyes with preoperative treatment. At 28 days, central subfield
macular thickness (CSMT) increased 2.2 ± 20.2 μm in eyes without
preoperative treatment, when compared 0.1 ± 25.2 μm (p = 0.670) in eyes
with preoperative treatment. At 3 months, the respective CSMT change
from baseline was −1.5 ± 26.9 μm and −3.4 ± 26.2 μm (p = 0.762). None of
the eyes were reported with pseudophakic cystoid macular oedema (PCME)
in either group. Conclusion: Lack of preoperative anti-inflammatory
treatment does not impair recovery from surgery or predispose diabetic
patients to increased risk of PCME in eyes postoperatively treated with
combination therapy of prednisolone acetate and nepafenac.