This article is more than 5 years old. Information may no longer be current.
Surgeon: Proper NSAID dosing regimen key to avoiding CME
Click Here to Manage Email Alerts
HONG KONG — With patient expectations at their highest levels, especially in clear lensectomy, proper NSAID dosing is important in cataract surgery to avoid cystoid macular edema and the poor vision that can result, a surgeon said here.
"CME is the most frequent cause of visual decline following cataract surgery," Joseph Colin, MD, of Hopital Pellegrin, France, said in a presentation at the World Ophthalmology Congress. "CME development is due in part to a prostaglandin mediated breach of the blood-retinal barrier."
According to Dr. Colin, even minimal amounts of CME can be especially damaging in refractive lens exchange due to its impact on vision with multifocal IOLs for patients who are expecting greatly improved vision.
Given properly, NSAIDs are able to limit prostaglandin formation, a major cause of postoperative CME, Dr. Colin said.
According to Dr. Colin, 80% of ophthalmologists in France currently use NSAIDs in cataract surgery. While he sees NSAIDs as an essential part of cataract surgery prophylaxis, they are also associated with several side effects, such as burning and irritation, superficial punctate keratitis and delayed wound healing. Corneal thinning and perforation from melts have also been reported, he said.
For patients not at risk of CME, Dr. Colin recommended a dosing regimen with Voltaren (diclofenac sodium ophthalmic solution 0.1%, Novartis) for 1 or 2 days preop and for 4 weeks after surgery. At-risk patients should receive dosing 1 week before surgery and for 8 weeks after.
"Proper NSAID prophylaxis is key to good surgical outcomes," Dr. Colin said.