Discussion
diabetic retinopathy, diabetic ME, inflammation, cataract, diabetic, post-phacoemulsification, diabetes
DIABETIC RETINOPATHY, INFLAMMATION, FOLLOWING CATARACT SURGERY, CATARACT, INSULIN-DEPENDENT DIABETES MELLITUS, DIABETES
In the current Randomized Clinical Trial (RCT), we investigated the prophylactic effect of ketorolac eye drop on post-phacoemulsification macular thickening in diabetic patients. We found that prophylactic ketorolac tromethamine 0.5% initiated the day before the surgery and continued up to 4 weeks in addition to topical corticosteroid was not associated with better visual outcome or lower macular thickness after the cataract surgery, compared to placebo except for follow- up in week 12, which was in favor of the ketorolac group. As well, the mean change in CMT was similar between the two study groups.There are several studies in the literature investigating the prophylactic or therapeutic effects of NSAIDs on ME following cataract surgery. Sivaprasa et al. evaluated the effects of NSAIDs on the treatment of acute and chronic ME following cataract surgery in a systematic review that included seven RCTs [Ticly et al. [Furthermore, the prophylactic effect of topical ketorolac against the development of post-cataract surgery ME in diabetic patients was evaluated by Elsawy et al. [The risk factors for the increase of macular thickness after phacoemulsification in diabetic patients are not well defined. However, some factors are diagnosed to increase the risk of macular thickening such as the presence of insulin-dependent diabetes mellitus, duration of diabetes ≥ 10 years, the severity of diabetic retinopathy, and prior treated diabetic ME. The results of the present study are in contrast to the findings of Elsawy et al., [Our study has significant limitations. A low sample size in each group may influence the statistical significance of the results. Also, we did not subgroup analysis based on diabetic retinopathy stages and normal eyes. Also maybe some confounding factors such as surgery time, cataract severity, and post-operation inflammation level influence our results and also the lack of fluorescein angiography imaging was a possible limitation of the current study.