Get access

Use of a cyclo-oxygenase 2 inhibitor for prophylaxis of cystoid macular oedema following cataract surgery: a randomized placebo-controlled trial

Authors

  • Andrew F Riley MBChB,

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author
  • Laura A Wakely MBChB,

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author
  • Hussain Y Patel MBChB,

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author
  • Bridget Neveldsen MBChB,

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author
  • Gordon L Purdie BSc,

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author
  • Anthony P Wells MBChB FRANZCO

    1. Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medicine, University of Otago, Wellington, New Zealand
    Search for more papers by this author

  • Presented as a scientific paper at the Royal Australian College of Ophthalmologists Annual Scientific Congress, Auckland, New Zealand, November 2003 and winner of Tyco Wellington Registrar award 2003.

Dr Tony Wells, Ophthalmology Unit, Department of Surgery and Anaesthesia, Wellington School of Medical, University of Otago, Private Bag 7343, Wellington, New Zealand. Email: twells@eyetext.net

Abstract

Background:  To assess the efficacy of Celecoxib, a cyclo-oxygenase 2 (COX-2) inhibitor, as prophylaxis for cystoid macular oedema after routine cataract surgery.

Methods:  A prospective, randomized, double-blind placebo-controlled trial of 69 hospital patients undergoing cataract surgery. Celecoxib 200 mg twice daily or placebo was given immediately after surgery for 14 days. Optical coherence tomography was used to quantify macular thickness before surgery and on day 1, week 2 and week 6 after surgery.

Results:  Sixty-nine patients were enrolled, of which 33 received placebo and 36 received active drug. Clinically apparent cystoid macular oedema occurred in four of the treatment group and two of the placebo group (= 0.68). No difference in best-corrected visual acuity was seen at 6 weeks (= 0.37). Covariate analysis of the results at 2 weeks and 6 weeks showed a macular thickness of 3% less in the treatment group compared with placebo (= 0.050).

Conclusion:  Celecoxib may decrease macular thickening following routine cataract surgery at 2 and 6 weeks after surgery as measured by Stratus OCT III. No difference in best-corrected visual acuity or clinically apparent cystoid macular oedema was seen. Further investigation of COX-2 inhibitors in a larger prospective randomized trial is required.

Ancillary