Topical NSAIDs may lessen odds of cystoid macular edema after cataract surgery

Issue: January 25, 2016

The use of topical NSAIDs as well as combination therapy with topical corticosteroids may decrease the odds of patients developing cystoid macular edema after cataract surgery, according to a study.

The systematic review and meta-analysis compared randomized controlled trials to determine optimal medical strategies to prevent cystoid macular edema (CME) after cataract surgery in nondiabetic, mixed and diabetic populations.

Of the nine trials performed in nondiabetic patients, topical NSAIDs significantly reduced the odds of developing CME after cataract surgery vs. topical corticosteroids. Additionally, a combination of topical NSAIDs and corticosteroids significantly reduced the odds of developing CME as compared with topical corticosteroids, but a combination treatment did not show any benefit over topical NSAIDs in an indirect treatment comparison, suggesting that topical NSAIDs “should always be part of the preventive treatment after cataract surgery in nondiabetic patients,” the study authors said.

Of the four trials performed in the mixed populations, including both diabetic and nondiabetic patients, topical NSAIDs significantly reduced the odds of developing CME after cataract surgery compared with topical corticosteroids.

Of the seven trials performed within the diabetic population, a combination of topical corticosteroids and NSAIDs significantly reduced the odds of developing CME vs. topical corticosteroids and showed a larger improvement in corrected distance visual acuity. Additionally, “an indirect comparison showed no statistically significant difference in the odds of developing CME after intravitreal corticosteroid vs. intravitreal anti-VEGF injections in diabetic patients who also received topical corticosteroids,” the study authors said. – by Kristie L. Kahl

Disclosure: Wielders reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Wielders LHP, et al. Am J Ophthalmol. 2015;doi:10.1016/j.ajo.2015.07.032.