Topical non-steroidal anti-inflammatory drugs for the treatment of cystoid macular edema post Descemet’s stripping automated endothelial keratoplasty

Abstract Introduction: To compare the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAID), corticosteroid (CS), and a combination of both drugs to prevent cystoid macular edema (CME) after cataract surgery. Methods We searched Pubmed, Cochrane Library, and Embase electronic databases to assess the relevant randomized controlled trials (RCTs) up to 28 April 2021. Network meta-analysis was registered on PROSPERO (CRD42020182520). Results Twenty-four RCTs were included in this review. The NSAID and combination of both drugs were significantly reduced the risk of developing CME than CS alone in non-diabetics and mix population. In the ranking profiles, the combination therapy showed a significant advantage over the single drugs and was less likely to develop CME. Diclofenac was the most likely to reduce the odds of developing CME compared with bromfenac and nepafenac. Dexamethasone was the most likely to reduce the odds of developing CME compared with betamethasone and fluorometholone. Conclusion NSAID combination with CS has significantly reduced the risk of developing CME postoperatively than the single drug. Diclofenac was superior to bromfenac and nepafenac in preventing CME. Dexamethasone was superior to betamethasone and fluorometholone in preventing CME.

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The Use of Topical Non-steroidal Anti-inflammatory Drugs for Uveitic Cystoid Macular Edema

Ocular Immunology and Inflammation ◽

10.1080/09273948.2016.1269931 ◽

2017 ◽

Vol 26 (5) ◽

pp. 795-797 ◽

Cited By ~ 2

Author(s):

Harry Petrushkin ◽

Duncan Rogers ◽

Carlos Pavesio

Keyword(s):

Macular Edema ◽

Cystoid Macular Edema ◽

Inflammatory Drugs ◽

Anti Inflammatory

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Effect of Non-Steroidal Anti-Inflammatory Drugs on Cystoid Macular Edema in Diabetic Patients after Cataract Surgery

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2013.54.3.427 ◽

2013 ◽

Vol 54 (3) ◽

pp. 427 ◽

Cited By ~ 2

Author(s):

Chang Hyun Koh ◽

Sung Kun Chung

Keyword(s):

Cataract Surgery ◽

Macular Edema ◽

Cystoid Macular Edema ◽

Diabetic Patients ◽

Inflammatory Drugs ◽

Anti Inflammatory

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The Effectiveness Analysis of Joint Use of Different Groups Anti-Inflammatory Drugs Treatment and Prevention of Cystoid Macular Edema in Patients after Phacoemulsification

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-2-214-218 ◽

2018 ◽

Vol 15 (2) ◽

pp. 214-218

Author(s):

Yu. I. Pirogov ◽

A. Yu. Bovykina

Keyword(s):

Macular Edema ◽

Cystoid Macular Edema ◽

Postoperative Treatment ◽

Eye Drops ◽

Treatment And Prevention ◽

Effectiveness Analysis ◽

Retinal Pathology ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Positive Effect

Purpose: to analyze the results of the joint eye drops application of 0.09 % solution of bromfenac and 0.1 % solution of dexamethasone and subtenons triamcinolone injection for treatment and prevention of cystoid macular edema (CME) in patients after phacoemulsification.Patients and methods: The study included 914 patients (1147 eyes) which held phacoemulsification with IOL implantation. Depending on the postoperative treatment patients randomized into two groups. Patients of the first group received instillation of eye drops of antibiotics-fluoroquinolones and 0.1 % dexamethasone. Patients of the second group were prescribed instillation of eye drops of 0.09 % solution of bromfenac in addition to the treatment. In each group the patients diagnosed CME after phacoemulsification were divided into subgroups depending on the presence or absence of concomitant involution of retinal pathology. In cases of diagnosis of macular edema after phacoemulsification (2nd group of patients) periocular triamcinolone injections were made.Results. The efficacy of bromfenac was estimated by the number of cases of postoperative CME in the compared groups. In patients of the first group, complications occurred in 3.1 % of cases. In patients of the second group the number of complications was significantly lower (1.5 %), including a significant reduction in the incidence of CME observed in patients without concomitant of macular pathology (AMD and epiretinal fibrosis). A combination of steroid and NSAID in the treatment of CME provides the regression of macular edema in all patients, regardless of the presence of involution macular pathology. The positive effect of periocular triamcinolone injections in the treatment of anti-inflammatory eye drops was noted in 8 of 9 cases a month after the first injection.

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