open access publication

Article, 2024

Steroids and/or Non-Steroidal Anti-Inflammatory Drugs as Postoperative Treatment after Trabeculectomy—12-Month Results of a Randomized Controlled Trial

Journal of Clinical Medicine, ISSN 2077-0383, Volume 13, 3, 10.3390/jcm13030887

Contributors

Ahmadzadeh A. 0000-0002-4295-4668 (Corresponding author) [1] Kessel L. 0000-0002-9375-1510 [1] [2] Schmidt B.S. 0000-0001-5302-9489 [3] Kolko M. 0000-0001-8697-0734 [1] [2] Bach-Holm D. 0000-0001-8249-5104 [1] [2]

Affiliations

  1. [1] Rigshospitalet
  2. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  3. [2] University of Copenhagen
  4. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  5. [3] Technical University of Denmark
  6. [NORA names: DTU Technical University of Denmark; University; Denmark; Europe, EU; Nordic; OECD]

Abstract

This prospective randomized controlled trial aimed to compare the efficacy and safety of topical preservative-free diclofenac (DICLO) to dexamethasone (DEX) eyedrops, and their combination (DEX+DICLO) after trabeculectomy. Sixty-nine patients with medically uncontrolled glaucoma were randomized to receive topical postoperative treatment with DICLO (n = 23), DEX (n = 23), or a combination of DEX and DICLO (n = 23). The primary outcome was the intraocular pressure (IOP) 12 months postoperatively. Secondary outcomes included surgical success, failure, visual field, and visual acuity from baseline to 12 months postoperatively. IOP reached the lowest point one day after trabeculectomy. At 12 months, IOP was 10.0 mmHg (95% CI, 8.4–11.6 mmHg) for DICLO, 10.9 mmHg (95% CI, 9.4–12.3 mmHg) for DEX, and 11.2 mmHg (95% CI, 9.1–13.3 mmHg) for DEX+DICLO. There were no significant differences in IOP, surgical success, failure, visual field, or visual acuity between the DICLO, DEX, or DEX+DICLO groups. We found that topical diclofenac was not statistically different from topical dexamethasone in controlling IOP 12 months after trabeculectomy. Combining diclofenac and dexamethasone offered no added IOP control compared to dexamethasone alone.

Keywords

NSAID, glaucoma, intraocular pressure, steroid, trabeculectomy

Funders

  • Henry og Astrid Møllers Fond
  • Gangsted Fond
  • Synoptik-Fonden
  • Fabrikant Einar Willumsens Fond, Aase og Ejnar Danielsens Fond
  • Danish Eye Research Foundation
  • Fight for Sight Denmark

Data Provider: Elsevier