Eyeworld

14 | EYEWORLD | JULY 2021 ASCRS/EYEWORLD JOURNAL CLUB ASCRS NEWS by Matthew Santos, MD, and Arsham Sheybani, MD eyes free from ocular comorbidities such as uveitis, glaucoma, or diabetes. Patients with significant complications to surgery such as pos- terior capsule rupture/vitreous loss, choroidal hemorrhage, or dislocated lens material were also excluded. The authors described their standard phacoemulsification technique with IOL implan- tation in the bag performed by surgeons who had performed at least 1,000 cataract surgeries in the 2 years prior to the study. The primary outcome was the objective change in anterior chamber flare as measured by the laser flare photometer. They also examined the number of AC cells at the postoperative visit, change in corrected distance visual acuity, and change in IOP. The authors reported numerous adverse events including pain/soreness, insufficiently controlled AC inflammation, and elevated IOP >25 mm Hg, among others. Physicians were able to initiate additional anti-inflammatory treatment at their discretion if postoperative inflammation appeared uncontrolled. Review of "Effect of anti-inflammatory regimen on early postoperative inflammation after cataract surgery" C ataract extraction with IOL implanta- tion is a commonly performed surgery. Efficient and effective postoperative control of inflammation helps ensure the high-quality, successful outcomes expected by both physicians and patients. While many postoperative regimens have been described, the mainstays of therapy include glucocorticoid (steroids) and non-steroidal anti-inflammatory drugs (NSAIDs), either as monotherapy or in combination. Some studies have suggested that NSAID eye drops may be superior in preventing pseudophakic cystoid macular edema. 1–5 Postoperative inflammation is seen on slit lamp exam by counting inflamma- tory cells and in observing the Tyndall scatter, or flare, caused by an increased concentration of protein in the aqueous humor of an inflamed anterior chamber (AC). 6,7 This may be objective- ly measured with a laser flare photometer. In this prospective, randomized, controlled trial, Erichsen et al. used this laser flare photometer to measure early postoperative inflammation, analyzing the effects of different prophylactic anti-inflammatory treatments. Design and methods The authors included five different treatment groups in their study. Two used prednisolone acetate and ketorolac in combination, with one group starting drops 3 days before surgery and the other starting drops on the day of surgery (Pred+NSAID-Pre and Pred+NSAID-Post). Two groups used ketorolac alone, with one group starting 3 days before, and one group starting the day of surgery (NSAID-Pre and NSAID-Post). Finally, the Dropless surgery group received a subtenon depot of 0.5 mL dexamethasone at the time of surgery. The Pred+NSAID-Pre group served as the control. Participants were recruited among patients referred for cataract surgery at a single center, undergoing surgery from early 2018 to late 2019. The exclusion criteria far outnumbered the inclusion criteria. These were routine cata- ract surgeries performed in otherwise healthy Arsham Sheybani, MD Residency Program Director Washington University in St. Louis St. Louis, Missouri Matthew Santos, MD Ophthalmology Resident Washington University in St. Louis St. Louis, Missouri The ASCRS Journal Club is a virtual, compli- mentary CME offering exclusive to ASCRS members that brings the experience of a lively discussion of two current articles from the Journal of Cataract & Refractive Surgery to the viewer. Co-moderated by Nick Mamalis, MD, and Leela Raju, MD, the March session featured a presentation by Divya Srikumaran, MD, co-author of "Impact of reduced elective ophthalmic surgical volume on U.S. hospitals during the early COVID-19 pandemic." The second manu- script, "Effect of anti-inflammatory regimen on early postoperative inflammation after cataract surgery," was presented by Matthew Santos, MD, ophthalmology resi- dent, Washington University in St. Louis. To view the March Journal Club session, visit ascrs.org/clinical-education/journal-club/ schedule/march-2021.

• Blank Page
• Blank Page (1)