scholarly journals Prophylactic non-steroidal anti-inflammatory drugs for the prevention of macular oedema after cataract surgery

Author(s):  
Blanche X Lim ◽  
Chris HL Lim ◽  
Dawn K Lim ◽  
Jennifer R Evans ◽  
Catey Bunce ◽  
...  
2021 ◽  
Vol 14 (6) ◽  
pp. e240562
Author(s):  
Matthew Gillam ◽  
Theresa Richardson

Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.


2005 ◽  
Vol 15 (5) ◽  
pp. 598-606 ◽  
Author(s):  
P. Russo ◽  
V. Papa ◽  
S. Russo ◽  
A. Dl Bella ◽  
G. Pabst ◽  
...  

Purpose To investigate whether topical nonsteroidal anti inflammatory drugs (NSAIDs) are useful, in the absence of concomitant corticosteroid therapy, in limiting postoperative inflammation after uncomplicated cataract surgery. Methods A total of 328 patients were enrolled in a prospective, randomized, double-masked, parallel-group, active-controlled study. Anterior chamber inflammation (ACI) was evaluated as the primary efficacy parameter. Only patients with moderate inflammation (ACI score of ≤4) the day after surgery were randomized and treated with NSAIDs. A novel topical formulation containing 0.2% sodium naproxen was compared with 0.1% diclofenac. Both were administered three times a day for 14 consecutive days. Ocular inflammation was measured after 7 and 14 days by using slit-lamp biomicroscopy. Safety parameters were also evaluated at the same time. Results Both treatments were equally effective in controlling postsurgical inflammation. No statistically significant differences between treatment groups were observed for the safety variables. No serious adverse events (AEs) occurred during the course of the study. The most frequent AE reported with naproxen was eye redness. Conclusions NSAIDs can effectively be used without concurrent administration of corticosteroids to control postoperative inflammation after uncomplicated cataract surgery. In addition, naproxen ophthalmic solution may be considered a suitable alternative to the currently available NSAIDs.


2012 ◽  
Vol 06 (05) ◽  
pp. 290
Author(s):  
Conceição Lobo ◽  

Cystoid macular oedema (CMO) is a primary cause of reduced vision after cataract surgery even after uneventful surgery. The incidence of clinical CMO following modern cataract surgery is 1.0-2.0 % but the high number of surgeries performed worldwide makes this entity an important problem. Pre-existing conditions such as diabetes and intra-operative complications increase the risk of developing CMO post-operatively. CMO is caused by an accumulation of intra-retinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of the breakdown of the blood-retinal barrier. The mechanisms that lead to this condition are not completely understood. However, the principal hypothesis is that the surgical procedure is responsible for the release of inflammatory mediators, such as prostaglandins. Optical coherence tomography is at present an extremely useful non-invasive diagnostic tool. Guidelines for the management CMO should be focused essentially on prevention and are based on the principal pathogenetic mechanisms, including the use of anti-inflammatory drugs.


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