Topical nepafenac 0.1% alone versus prednisolone acetate 1% as postoperative anti-inflammatory agents in small gauge vitrectomy.

AIM: To compare the efficacy of postoperative topical nepafenac (0.1%) with prednisolone acetate (1%) as anti-inflammatory agents in eyes undergoing Transscleral Sutureless Vitrectomy (TSV). SETTINGS AND DESIGN: Prospective, double-blind, randomized, single center clinical study. MATERIALS AND METHODS: Eighty eyes of 76 subjects, who underwent small gauge vitrectomy, were included in the study. The subjects who fulfilled the inclusion criteria were randomized to either topical nepafenac only (Group 1) or prednisolone acetate only (Group 2), to be used as postoperative anti-inflammatory agents. The subjects were reviewed on days 1, 30, and 90. Ocular and adnexal inflammation was appropriately graded using the standardized classification. Grading of ocular pain was done on the Visual Analog Scale (VAS). STATISTICAL ANALYSIS: The Wilcoxon rank-sum test, using two-sided analysis, was used. RESULTS: During the follow-up, both Group 1 and Group 2 did not have a significant difference related to the grade of the anterior chamber inflammation (P > 0.05) or adnexal inflammation (P > 0.05). Pain perception was less in the subjects in Group 1 as compared to subjects in Group 2, but was not statistically significant (P > 0.05). CONCLUSION: Postoperative topical nepafenac was non-inferior to prednisolone acetate in reducing postoperative ocular inflammation in eyes undergoing TSV.

Evaluation of Wound Morphology of Sclerotomy Sites of Sutureless Vitrectomy Using Spectralis Anterior Segment Optical Coherence Tomography.

PURPOSE: The aim of the study was to evaluate wound morphology in vivo in eyes undergoing sutureless vitrectomy. DESIGN: This was a prospective consecutive case series. METHODS: Twenty eyes undergoing sutureless vitrectomy were evaluated using anterior segment optical coherence tomography on days 1, 15, and 30. Ten eyes each belonged to 23-gauge (group A) and 25-gauge (group B). Scans were taken on the incision sites. Group A cases were further divided into group A1 and A2 on the basis of the surgical time of less than 15 minutes' and more than 15 minutes' duration, respectively. RESULTS: On day 1, the mean outer and inner incision diameters in group A were 236.6 and 146 µm, and those for group B were 118.6 and 90 µm. A significant decrease (P < 0.0001) in both the port sizes was observed in both groups' follow-up. Group B showed significant decrease (P < 0.0001) in the port sizes on l follow-up as compared with group A. Group A1 had smaller incision size as compared with group A2 on the first postoperative day, although not statistically significant(P > 0.05). CONCLUSIONS: In both groups, the sclerotomy incisions showed good healing at 1-month duration. The 25-gauge sclerotomies showed better healing characteristics of wound morphology as compared with the 23-gauge sclerotomies.