Comparison of topical nepafenac 0.1% and 0.3% for the treatment of pseudophakic cystoid macular edema following cataract surgery

To compare the effectiveness of topical nepafenac 0.1% and 0.3% in the management of pseudophakic cystoid macular edema (PCME) following cataract surgery.

In this retrospective comparative study, patients with PCME after cataract surgery and a follow-up of at least three months were included. Patients were assigned to two groups according to the topical nepafenac treatment initiated after PCME diagnosis: 0.1% (Group-1) or 0.3% nepafenac (Group-2). Best-corrected visual acuity (BCVA), macular and choroidal parameters assessed by optical coherence tomography (OCT) were evaluated at diagnosis and during follow-up and were compared between the groups.

The study included 97 eyes from 78 patients, with a mean age of 71.3 ± 7.1 years. Baseline demographic characteristics and surgical parameters were comparable between the groups. BCVA, macular and choroidal parameters improved in both groups during follow-up. At the third month, Group-1 showed significantly better mean BCVA (0.056 ± 0.082 vs. 0.122 ± 0.135, p = 0.028). At the first month, mean central foveal subfield thickness was significantly thinner in Group-1 (348.0 ± 96.5 vs. 387.9 ± 130.7, p = 0.047). Mean choroidal vascular index (CVI) increased during follow-up in both groups, with a greater increase observed in Group-2 at the first month (0.5 ± 2.7 vs. 2.1 ± 3.7, p = 0.024). Complete anatomical response at the first month was observed more often in Group-1 (60.0% vs. 38.1%, p = 0.033).

Topical nepafenac 0.1% and 0.3% were both associated with improvement in PCME. Group-1 showed better early anatomical and later visual outcomes, whereas Group-2 showed a greater early CVI increase. However, these findings do not establish the superiority of either regimen.