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AbuBakar Riaz
Madina teaching Hospital Faisalabad.

Amir Ali Choudhry
Madina teaching Hospital Faisalabad.

DOI: https://doi.org/10.5281/zenodo.24036990

Keywords: Diabetic macular edema; Optical coherence tomography; Anti-inflammatory agents, non-steroidal; Phacoemulsification; Macular thickness; Cataract.

Abstract

Objective. To compare the mean change in macular thickness measured by OCT in patients with DME undergoing phacoemulsification with and without topical NSAIDs. Methods. This quasi-experimental, non-randomized, two-group comparative study was carried out at the Department of Ophthalmology, Madinah Teaching Hospital, Faisalabad. A total of 190 eyes with OCT-confirmed DME scheduled for elective phacoemulsification were allocated by treatment received to topical NSAID (Group A, n = 95) or no NSAID (Group B, n = 95). CMT was recorded at baseline and postoperatively, with day 45 as the primary endpoint. Change in CMT was defined as postoperative minus preoperative CMT. Groups were compared using the independent-samples t test, and an ANCOVA model adjusted for baseline CMT and clinical covariates.Results. The groups were comparable at baseline (all p > 0.05); preoperative CMT was 349.33 ± 24.09 µm in Group A and 349.66 ± 22.29 µm in Group B (p = 0.920). At day 45, CMT was 348.06 ± 33.60 µm in Group A and 386.11 ± 35.98 µm in Group B. The mean change was −1.26 ± 24.44 µm in Group A and +36.44 ± 25.79 µm in Group B. The between-group difference in mean change was 37.71 µm (95% CI 30.51 to 44.90; p < 0.001; Cohen d 1.50). After adjustment for baseline CMT and covariates, the difference remained (36.81 µm; 95% CI 29.61 to 44.01; p < 0.001).Conclusion. In this non-randomized study, topical NSAID use was associated with a smaller increase in macular thickness after phacoemulsification in patients with DME. Because of the observational allocation, the findings indicate association rather than causation, and randomized trials are required to confirm them.