Efficacy of Bromfenac 0.09% in Prevention and Treatment of Pseudophakic CME When Used Preoperatively and Postoperatively

byMelissa M. Cable, MD, FAAO, FACS

Discover Vision Centers

*Author has relationships with thefollowing companies with or without

honoraria: Allergan, Alcon, B&L,Ista, Inspire, Ocular Therapeutix

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Purpose• To evaluate the efficacy of a topical ophthalmic

non-steroidal anti-inflammatory in preventing symptomatic pseudophakic cystoid macular edema in the initial three months following phacoemulsification surgery when dosed pre and post-operatively.

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Methods• Retrospective review of 1020 charts of all

patients who had uneventful phacoemulsification and intraocular lens placement by one surgeon over a 30 month time period.

• Patients were instructed to use bromfenac 0.09%

(ISTA Pharmaceuticals) twice daily beginning three days prior to surgery and twice daily until gone after surgery.

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Methods• Patients were evaluated with Snellen visual

acuity chart at one day, one week, six weeks, and for any interim visits.

• Patients underwent dilated fundus exam with 90 diopter lens at one week.

• Patients with decreased vision and/or suggestive fundus findings were referred for macular OCT and/or fluorescein angiography.

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Results• Five eyes of three patients of 1020 cases (0.5%)

were confirmed to have pseudophakic cystoid macular edema by OCT and in two cases, additional confirmation by flourescein angiography was obtained.

• In this group one patient had documented pre-existing epiretinal membrane.

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Results• The mean onset of pseudophakic cystoid macular

edema was five weeks with a mean visual acuity at that time of logmar -0.416 (app. 20/50).

• Mean time to resolution after onset of pseudophakic cystoid edema was 7.6 weeks and resolution was confirmed by OCT.

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Results• Mean age of patients diagnosed was 66 years of

age.

• Final best corrected visual acuity was logmar -0.15 (20/30). There were no adverse ocular or systemic events.

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Conclusion• Bromfenac 0.09% used bid three days prior to

phacoemulsification and lens implantation and bid until gone after surgery appears to be highly effective in preventing pseudophakic cystoid macular edema.

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Conclusion• In this study, two patients without systemic or

ocular risk factors experienced pseudophakic CME.

• Treatment of pseudophakic CME with bromfenac 0.09% appears to be an effective way to reduce the signs of CME by OCT and improve visual acuity.

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About the AuthorMelissa M. Cable, MD, FAAO, FACS, is a board-certified

ophthalmologist with Discover Vision Centers in Kansas City, MO., specializing in gentle no-stitch cataract surgery, ocular disease and cosmetic procedures.

Dr. Cable graduated at the top 5% of her class in both her undergraduate and medical degree programs at Louisiana State University. She completed a residency in ophthalmology at the University of Missouri—Kansas City before joining Discover Vision Centers in 1999. Dr. Cable is one of only six partners in the company. With 35 doctors, 9 locations and 3 surgery centers located in the Kansas City Metro area, Discover Vision Centers has become one of the largest private ophthalmic medical-surgical practices in the United States.

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Thank you!

Contact Information: Melissa M. Cable, MD, FAAO, FACSPartner – Discover Vision Centers, Kansas CityPhone: 816.478.1230 Fax: 816.478.4413 E-mail: mcable@discovervision.com www.discovervision.com