December 26, 2012
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Incidence of cystoid macular edema lowered with prophylaxis, topical steroids

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Following phacoemulsification, the incidence of cystoid macular edema may be reduced with prophylaxis and the use of topical steroidal and nonsteroidal agents, according to a study.

Perspective from I. Howard Fine, MD

The retrospective review included 2,862 phacoemulsification procedures performed over a 5 year period.

Acute postoperative cystoid macular edema (CME) was confirmed in 3 cases (0.1%) within the 3 month postoperative period. Topical prophylaxis with prednisolone acetate and ketorolac tromethamine 0.4% was started 1 day postoperatively for diabetic patients and patients implanted with an anterior chamber IOL.

Of the three patients with CME, one had a history of diabetic retinopathy; the other two patients were implanted with a posterior chamber IOL due to uneventful phacoemulsification, and one of these patients was further implanted with anterior chamber IOL due to damage to the capsule.

“Although not a randomized prospective study, we believe this finding will help substantiate the widely held view that topical steroidal and nonsteroidal agents help reduce the frequency of CME,” the study authors said. “If the incidence of CME in this study applies generally, it would be harder to successfully and ethically perform a randomized trial of medical prophylaxis.”