Non-steroidal anti-inflammatory agents for treating cystoid macular oedema following cataract surgery

Abstract

This review found two trials which showed that topical NSAID (0.5% ketorolac tromethamine ophthalmic solution) has a positive effect on chronic CMO and two trials which revealed no significant difference between comparative groups. As such, the effects of NSAIDs in acute and chronic CMO remain unclear and needs further investigation.

Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review

“…Sivaprasad et al performed a systematic review of the efficacy of different topical NSAIDs for the treatment of post-operative acute and chronic CMO [ 64 ]. Regarding acute CMO (defined as oedema of less than four months), they found that a combined treatment with ketorolac and corticosteroid and monotherapy with either ketorolac or diclofenac were all effective.…”

Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review

“…Sivaprasad et al performed a systematic review of the efficacy of different topical NSAIDs for the treatment of post-operative acute and chronic CMO [ 64 ]. Regarding acute CMO (defined as oedema of less than four months), they found that a combined treatment with ketorolac and corticosteroid and monotherapy with either ketorolac or diclofenac were all effective.…”

Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

“…Of 1863 systematic reviews on eyes and vision in our database as of March 2016, we identified 99 that evaluated management strategies for cataract in the adult eye and were eligible for this project (Figure 1). The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews .…”

“… The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews . Of the 79 non-Cochrane reviews, 50 (63%) were published in specialty medical journals (eg, Ophthalmology ).…”

Customized clinical practice guidelines for management of adult cataract in Iran

“…[ 180 181 182 183 184 185 186 187 ] (III), (A 2 8) - (IV), (Internal and external consensus) To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus) Before performing Nd: YAG laser capsulotomy for treatment of PCO, patients at high risk of retinal detachment (RD) such as posterior capsule rupture in the other eye, axial length more than 23 mm, and male sex, should be informed of the possibility of RD following laser capsulotomy. [ 190 ] (II), (C63) Postoperative intraocular inflammation is considered as a risk factor for corneal, trabecular and retinal complications, therefore the use of steroids or NSAIDs immediately after surgery to reduce inflammation is recommended.…”

“…To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus)…”

Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review

“…Sivaprasad et al performed a systematic review of the efficacy of different topical NSAIDs for the treatment of post-operative acute and chronic CMO [ 64 ]. Regarding acute CMO (defined as oedema of less than four months), they found that a combined treatment with ketorolac and corticosteroid and monotherapy with either ketorolac or diclofenac were all effective.…”

Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

“…Of 1863 systematic reviews on eyes and vision in our database as of March 2016, we identified 99 that evaluated management strategies for cataract in the adult eye and were eligible for this project (Figure 1). The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews .…”

“… The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews . Of the 79 non-Cochrane reviews, 50 (63%) were published in specialty medical journals (eg, Ophthalmology ).…”

Customized clinical practice guidelines for management of adult cataract in Iran

“…[ 180 181 182 183 184 185 186 187 ] (III), (A 2 8) - (IV), (Internal and external consensus) To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus) Before performing Nd: YAG laser capsulotomy for treatment of PCO, patients at high risk of retinal detachment (RD) such as posterior capsule rupture in the other eye, axial length more than 23 mm, and male sex, should be informed of the possibility of RD following laser capsulotomy. [ 190 ] (II), (C63) Postoperative intraocular inflammation is considered as a risk factor for corneal, trabecular and retinal complications, therefore the use of steroids or NSAIDs immediately after surgery to reduce inflammation is recommended.…”

“…To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus)…”

Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review

“…Sivaprasad et al performed a systematic review of the efficacy of different topical NSAIDs for the treatment of post-operative acute and chronic CMO [ 64 ]. Regarding acute CMO (defined as oedema of less than four months), they found that a combined treatment with ketorolac and corticosteroid and monotherapy with either ketorolac or diclofenac were all effective.…”

Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye

“…Of 1863 systematic reviews on eyes and vision in our database as of March 2016, we identified 99 that evaluated management strategies for cataract in the adult eye and were eligible for this project (Figure 1). The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews .…”

“… The earliest review was published in 1994, but more than half were published after 2012 (Table 2). Twenty of 99 reviews (20%) were published by CEV authors in The Cochrane Database of Systematic Reviews . Of the 79 non-Cochrane reviews, 50 (63%) were published in specialty medical journals (eg, Ophthalmology ).…”

Customized clinical practice guidelines for management of adult cataract in Iran

“…[ 180 181 182 183 184 185 186 187 ] (III), (A 2 8) - (IV), (Internal and external consensus) To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus) Before performing Nd: YAG laser capsulotomy for treatment of PCO, patients at high risk of retinal detachment (RD) such as posterior capsule rupture in the other eye, axial length more than 23 mm, and male sex, should be informed of the possibility of RD following laser capsulotomy. [ 190 ] (II), (C63) Postoperative intraocular inflammation is considered as a risk factor for corneal, trabecular and retinal complications, therefore the use of steroids or NSAIDs immediately after surgery to reduce inflammation is recommended.…”

“…To treat postoperative cystoid macular edema (CME), topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ketoralac 0.5 percent are recommended as the first step of therapy. [ 188 189 ] (I), (R4) - (IV), (Internal and external consensus)…”