Title : Can taflotan increase the risk of cystoid macular edema when used perioperatively in patients with open-angle glaucoma?
Abstract:
Macular edema is a disorder when the macular region of the retina of the eye becomes edematous due to an accumulation of excess fluid. Macular edema manifestations can range from mild ones that hardly affect vision to severe ones that cause substantial visual impairment. Numerous factors can lead to ME, such as diabetic retinopathy, age-related changes, inflammatory illnesses, glaucoma, vascular abnormalities, including vascular occlusion, reticulopathy, etc. (Iftikhar et al., 2023). Prostaglandins are inflammatory mediators that play a crucial role in many areas of eye physiology and pathology, including the development of Macular edema. PGs, particularly PGE2, have the ability to exacerbate inflammatory processes in vascular tissue, which may enhance the permeability of the vascular wall and cause fluid to build up in the macular region.
Currently, the safety of the use of prostoglandin analogues in the patients with concomitant cataracts and POAG during the perioperative period is a topical issue.
Objectives: Based on the findings of optical coherence tomography, to study in a comparative aspect the macular thickness changes in the patients with concomitant cataract and concomitant cataracts and primary open-angle glaucoma, instilled with Taflotan during the perioperative period.
Study design - Methods: The study included 80 patients (126 eyes). The patients were divided into 4 groups: Group 1, i.e. the control group included the patients without POAG. The patients in the remaining groups received different medications: Group 2 - Taflotan, 3rd Group - Azarga, and Group 4 - Taflotan + Azarga. Azarga, a fixed combination medication consisting of 1% brinzolamide and 0.5% timolol maliate. Taflotan (Santen, Japan), a PGA without preservatives containing 0.0015% tafluprost solution/
Following the surgery, the patients receiving the medications for lowering intraocular pressure were administered with fluoroquinolone, dexamethasone and a nonsteroidal anti-inflammatory drug. Prior to cataract phacoemulsification, the patients' maculae were imaged using optical coherence tomography on the 7th day, one month, and three months following the surgery, along with the determination of the macular thickness in the central, superior, inferior, nasal, and temporal regions. Nonparametric discriminant techniques (Pearson's chi-square), the Kruskal-Wallis Test (H-test), and F-test (or Fisher's criterion) were used in the statistical analysis, which was carried out using the IBM Statistics SPSS-22 and MS Excel 2016 statistical software packages.
Obtained results: Table. Results of perioperative use of Taflot and Azarg in patients with cataracts combined with POAG 3months after surgery
|
groups |
Indicators |
||||
|
intraocular pressure |
isual acuity |
No Redness of the conjunctiva |
No Tyndall effect |
Macular thickness is within normal limits |
|
|
1st group |
15,9±0,8 |
0,913 |
94,1% |
100% |
88,2% |
|
2nd group |
16,3±0,4 |
0,889 |
78,4% |
100% |
94,6% |
|
3rd group |
17,3±0,7 |
0,907 |
92,9% |
100% |
100% |
|
4th group |
16,9±,5 |
0,91 |
90,0% |
100% |
90% |
|
P |
>0,05 |
>0,05 |
|
>0,05 |
>0,05 |
As can be seen from the results 88.2% of patients in Group 1, 94.6% in Group 2, 100% in Group 3, and 90% in Group 4 (p>0.05). did not exhibit any increases in macular thickness exceeding the upper limits of the norm one month following the surgery.
Conclusions: Taflotan did not increase the risk of Cystoid Macular Edema as compared to the control and comparison groups.
Key words: cataracts, POAG, Taflotan, Azarga, macular thickness, Cystoid Macular Edema.
