Individualized treatment may be key in managing ocular inflammation after cataract surgery

David A. Goldman

MIAMI — A presenter here suggested individualized management of ocular inflammation following cataract surgery.

"I think it is important that whichever drug you choose, the dosage, frequency, should all be based on ocular inflammation and patient risk factors," David A. Goldman, MD, said at the Bascom Palmer Eye Institute 50th Anniversary Scientific Meeting. "It is really important to get inflammation under control as quick as possible."

Dr. Goldman advised anti-inflammatory treatment for all patients, noting that steroids and NSAIDs are used most commonly. This approach may reduce the risk of cystoid macular edema, decrease postoperative pain and control inflammation early on, he said.

When using topical corticosteroids, surgeons should consider that compliance decreases with increased number of drops and dosing frequency and that susceptibility to adverse effects varies by individual. Dr. Goldman also said that acute cases, particularly those with anterior chamber involvement, require aggressive management.

"More studies are needed to really confirm the best protocols for routine cataract surgery and evaluate different dosing regimens, including a more rapid tapering schedule, and looking at the potential for CME prevention and treatment," he added.

Additionally, Dr. Goldman suggested pressure monitoring for those who are prescribed anti-inflammatory medications for more than a week and tapering steroid use rather than stopping it abruptly.

Disclosure: Dr. Goldman is a consultant for Alcon, Allergan, Lumenis and OphthalmologyWeb.