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Visual outcomes after cataract surgery: topical nonsteroidal anti-inflammatory drug prophylaxis compared with prednisolone.
J Cataract Refract Surg. 2021 Jul 01; 47(7):870-877.JC

Abstract

PURPOSE

To compare visual outcomes in patients without a history of macular edema after phacoemulsification using combination topical nonsteroidal anti-inflammatory drug plus prednisolone with prednisolone alone.

SETTING

Kaiser Permanente Northern California, USA.

DESIGN

Retrospective cohort study.

METHODS

Information was obtained from the electronic health record. The first measure of corrected distance visual acuity (CDVA) recorded during the period 3 weeks to 1 year after phacoemulsification was obtained. Confounding factors and clustering of eyes within patients were adjusted using linear mixed effects regression models for the continuous outcome of CDVA improvement and general estimating equations for the dichotomous outcome of 20/20 or better vs 20/25 or worse.

RESULTS

The study included 62 700 health plan members of whom 26,309 (42%) used topical prednisolone alone, whereas 36,391 (58%) used combination treatment. The mean within-person change in CDVA from the preoperative measurement to the postoperative measurement was the same (-0.43 logMAR) for patients in the 2 groups. However, the group that received combination treatment was somewhat more likely to achieve CDVA of 20/20 or better (odds ratio 1.24 with 95% CI, 1.20-1.28).

CONCLUSIONS

In this large study of cataract surgery patients, a small statistically significant association of combination treatment compared with prednisolone alone was observed.

Authors+Show Affiliations

From the Departments of Ophthalmology and Quality, Kaiser Permanente, Walnut Creek, California (Shorstein); Department of Ophthalmology, Kaiser Permanente San Rafael, California (Carolan); Division of Research, Kaiser Permanente Northern California, Oakland, California (Liu, Alexeeff, Amsden, Herrinton).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33315744

Citation

Shorstein, Neal H., et al. "Visual Outcomes After Cataract Surgery: Topical Nonsteroidal Anti-inflammatory Drug Prophylaxis Compared With Prednisolone." Journal of Cataract and Refractive Surgery, vol. 47, no. 7, 2021, pp. 870-877.
Shorstein NH, Carolan J, Liu L, et al. Visual outcomes after cataract surgery: topical nonsteroidal anti-inflammatory drug prophylaxis compared with prednisolone. J Cataract Refract Surg. 2021;47(7):870-877.
Shorstein, N. H., Carolan, J., Liu, L., Alexeeff, S. E., Amsden, L. B., & Herrinton, L. J. (2021). Visual outcomes after cataract surgery: topical nonsteroidal anti-inflammatory drug prophylaxis compared with prednisolone. Journal of Cataract and Refractive Surgery, 47(7), 870-877. https://doi.org/10.1097/j.jcrs.0000000000000542
Shorstein NH, et al. Visual Outcomes After Cataract Surgery: Topical Nonsteroidal Anti-inflammatory Drug Prophylaxis Compared With Prednisolone. J Cataract Refract Surg. 2021 Jul 1;47(7):870-877. PubMed PMID: 33315744.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visual outcomes after cataract surgery: topical nonsteroidal anti-inflammatory drug prophylaxis compared with prednisolone. AU - Shorstein,Neal H, AU - Carolan,James, AU - Liu,Liyan, AU - Alexeeff,Stacey E, AU - Amsden,Laura B, AU - Herrinton,Lisa J, PY - 2020/07/17/received PY - 2020/11/23/accepted PY - 2020/12/15/pubmed PY - 2021/7/28/medline PY - 2020/12/14/entrez SP - 870 EP - 877 JF - Journal of cataract and refractive surgery JO - J Cataract Refract Surg VL - 47 IS - 7 N2 - PURPOSE: To compare visual outcomes in patients without a history of macular edema after phacoemulsification using combination topical nonsteroidal anti-inflammatory drug plus prednisolone with prednisolone alone. SETTING: Kaiser Permanente Northern California, USA. DESIGN: Retrospective cohort study. METHODS: Information was obtained from the electronic health record. The first measure of corrected distance visual acuity (CDVA) recorded during the period 3 weeks to 1 year after phacoemulsification was obtained. Confounding factors and clustering of eyes within patients were adjusted using linear mixed effects regression models for the continuous outcome of CDVA improvement and general estimating equations for the dichotomous outcome of 20/20 or better vs 20/25 or worse. RESULTS: The study included 62 700 health plan members of whom 26,309 (42%) used topical prednisolone alone, whereas 36,391 (58%) used combination treatment. The mean within-person change in CDVA from the preoperative measurement to the postoperative measurement was the same (-0.43 logMAR) for patients in the 2 groups. However, the group that received combination treatment was somewhat more likely to achieve CDVA of 20/20 or better (odds ratio 1.24 with 95% CI, 1.20-1.28). CONCLUSIONS: In this large study of cataract surgery patients, a small statistically significant association of combination treatment compared with prednisolone alone was observed. SN - 1873-4502 UR - https://www.unboundmedicine.com/medline/citation/33315744/Visual_outcomes_after_cataract_surgery:_topical_nonsteroidal_anti_inflammatory_drug_prophylaxis_compared_with_prednisolone_ L2 - https://doi.org/10.1097/j.jcrs.0000000000000542 DB - PRIME DP - Unbound Medicine ER -