Eyeworld

OCT 2019

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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24 | EYEWORLD | OCTOBER 2019 ASCRS NEWS EYEWORLD JOURNAL CLUB Contact information Sun: grs2003@med.cornell.edu predispose to increased macular thickness or PME. 18 Likewise, a systematic literature review by Hernstadt et al. concluded that PGA use was not associated with the development of clinically significant PME after cataract surgery regardless of the time point, suggesting that there is no evidence to support stopping PGA perioperatively. 19 In summary, this study indicates that pa- tients who continued latanoprost in the post- op period experienced a transient increase in CMT at 1 month, which resolved by 3 months, suggesting that patients without additional risk factors for PME can continue their PGA glau- coma medication after cataract surgery without additional risk to vision. As the authors note, further studies with larger sample sizes will be necessary to compare rates of incidence of clinical PME. Editor's note: The authors would like to acknowledge Dr. Paul Petrakos and Dr. Sarah Van Tassel for their support and guidance with this review. relationship include a prospective interventional case series by Walkden et al., which demon- strated an increased incidence of PME at 6 weeks postoperatively. 13 Similarly, a retrospec- tive study by Yeh et al. reported an association between latanoprost and the development of PME after uneventful cataract surgery. 14 Wand et al. conducted a prospective cohort study, which demonstrated the development of clin- ically symptomatic and angiographically docu- mented PME in post-cataract patients treated with latanoprost. 15 Arcieri et al. documented a statistically significant difference in foveal thick- ness between patients treated with latanoprost compared to placebo. 16 A case-control study by Wendel et al. showed an increased relative risk of PME development with postop use of the PGAs travoprost and bimatoprost, although the study was unable to prove a similar relationship with latanoprost. 17 Opposing evidence comes from a prospective interventional case series conducted by Moghimi et al., which found that use of latanoprost later than 4 months after uncomplicated cataract surgery does not continued from page 23 Cystoid macular edema following prostaglandin analogue use after uncomplicated cataract surgery in glaucoma patients: A randomized clinical trial Ghasem Fakhraie, MD, Masoud Mirghorbani, MD, L. Jay Katz, MD, Amirhossein Mollazadeh, MD, Zakieh Vahedian, MD, Reza Zarei, MD, Yadollah Eslami, MD, Masoud Mohammadi, MD, Nikoo Hamzeh, MD, Ahmad Masoomi, MD J Cataract Refract Surg. 2019;45(10):1436–1445. was repeated at postoperative months 1 and 3. Main outcome parameter was defined as the change in CMT between preoperative measurement and postoperative 1 and 3 months. n Results: 156 eyes finished the trial (latanoprost: 76 and DC: 80). There were no differences in demographic and baseline characteristics including preoperative CMT between the two groups. Transient mean increase in CMT developed in the latanoprost group at month 1 (12±49 µm; p=0.03), but the mean CMT was unchanged at month 3 compared to the baseline (6±55 µm; p=0.27). The difference in mean CMT change from baseline between the two groups was –3.1 (95% CI: –18.4 to 12.0; p=0.68) after 1 month and –10.5 (95% CI: –26.6 to 5.5; p=0.19) after 3 months; both were insignificant. n Conclusions: We did not find any measurable effect on macular thickness following latanoprost administration after cataract surgery. n Purpose: To evaluate the effect of postoperative latanoprost administration on central macular thickness (CMT) after uncomplicated cataract surgery in glaucoma patients. n Setting: Farabi Eye Hospital (tertiary referral center), Tehran, Iran n Design: Randomized clinical trial n Methods: Glaucoma patients treated with latanoprost who needed cataract surgery and had no other risk factor for development of pseudophakic macular edema (PME) were randomly allocated into two groups, continuation of latanoprost in one group and discontinuation (DC) of the drop in the other group, following uneventful cataract surgery. The trial was single- masked. Patients underwent complete ocular examination and measurement of central macular thickness (CMT) by optical coherence tomography (OCT) at baseline. OCT References continued 15. Wand M, et al. Latanoprost and cystoid macular edema in high-risk aphakic or pseudopha- kic eyes. J Cataract Refract Surg. 2001;27:1397–1401. 16. Arcieri ES, et al. Influence of topical latanoprost on foveal thickness in eyes that underwent uneventful cataract surgery. Arquivos Brasileiros de Oftalmolo- gia. 2008;71:629–634. 17. Wendel C, et al. Association of postoperative topical prostaglan- din analog or beta-blocker use and incidence of pseudophakic cystoid macular edema. J Glauco- ma. 2018;27:402–406. 18. Moghimi S, et al. Topical lat- anoprost does not cause macular thickening after uncomplicated cataract surgery. Journal Ophthal- mic Vis Res. 2012;7:289–294. 19. Hernstadt DJ, Husain R. Effect of prostaglandin analogue use on the development of cystoid mac- ular edema after phacoemulsifi- cation using STROBE statement methodology. J Cataract Refract Surg. 2017;43:564–569.

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