The role of perioperative nonsteroidal anti-inflammatory drugs use in cataract surgery

Brandsdorfer, Ari; Patel, Shuchi; Chuck, Roy S.

doi:10.1097/icu.0000000000000541

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…Prostaglandins play an important role in vasodilatation [ 56 ]. The use of NSAIDs in the postoperative management of patients undergoing cataract surgery has become a standard of care [ 57 , 58 ]. Routine use of anti-inflammatory eye drops following cataract surgery is highly effective in reducing post-surgical inflammation and the incidence of CME [ 59 ]; however, their role in the treatment of CME has not been studied widely.…”

Section: Discussionmentioning

confidence: 99%

Current Management Options in Irvine–Gass Syndrome: A Systemized Review

Orski¹,

Gawęcki²

2021

JCM

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Irvine–Gass syndrome (IGS) remains one of the most common complications following uneventful cataract surgery. In most cases, macular edema (ME) in IGS is benign, self-limiting, and resolves spontaneously without visual impairment; however, persistent edema and refractory cases may occur and potentially deteriorate visual function. Despite the relatively high prevalence of IGS, no solid management guidelines exist. We searched the PUBMED database for randomized clinical trials (RCT) or case series of at least 10 cases published since 2000 evaluating different treatment strategies in patients with cystoid macular edema (CME). The search revealed 28 papers that fulfilled the inclusion criteria with only seven RCTs. The scarceness of material makes it impossible to formulate strong recommendations for the treatment of IGS. Clinical practice and theoretical background support topical non-steroidal anti-inflammatory drugs (NSAIDs) as the first-line therapy. Invasive procedures, such as periocular steroids, intravitreal corticosteroids, and anti-vascular endothelial growth factor (anti-VEGF), are usually applied in prolonged or refractory cases. Results of novel applications of subthreshold micropulse laser (SML) are also promising and should be studied carefully in terms of the safety profile and cost effectiveness. Early initiation of invasive treatment for providing better functional results must be examined in further research.

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Section: Discussionmentioning

confidence: 99%

Current Management Options in Irvine–Gass Syndrome: A Systemized Review

Orski¹,

Gawęcki²

2021

JCM

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“…B. Interleukine) unterdrückt [39]. Zusätzlich wirken NSAR, bei präoperativem Beginn der Gabe, gegen eine reizinduzierte intraoperative Miosis durch eine Reduktion der intraoperativen Prostaglandinfreisetzung [40].…”

Section: Medikamentöse Therapieunclassified

“…Differenziert werden Studien zur iatrogenen Inflammation, Mydriasis sowie Prophylaxe von CME und Schmerzen postoperativ. Zwar wurde ein positiver Effekt von NSAR auf o. g. Parameter festgestellt, dennoch werden weitere qualitativ hochwertige Studien von den Autoren empfohlen [40].…”

Section: Kortikosteroideunclassified

Peri-/Postoperative antientzündliche Therapie nach Kataraktoperation und refraktiver Chirurgie

Lwowski

Robaulx

Kohnen

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungDie Kataraktoperation ist die häufigste Operation weltweit. Auch die refraktive Chirurgie erfreut sich steigender Beliebtheit. Obwohl die etablierten Eingriffe eine sehr niedrige Rate nicht infektiöser entzündlicher Komplikationen aufweisen, kann es zu postoperativen Veränderungen kommen. Relevant sind hier insbesondere das Makulaödem nach Kataraktchirurgie und die sterilen Entzündungen der Hornhaut nach refraktiver Hornhautchirurgie. Diese können durch eine Ingangsetzung von Entzündungskaskaden durch lokale Manipulation mit konsekutivem Einwandern von Entzündungszellen und entsprechender Reaktion des Gewebes entstehen. Aufgrund der hohen Anzahl an durchgeführten Eingriffen ist, trotz niedriger Inzidenz, eine hohe absolute Anzahl an Patienten von entsprechenden Veränderungen betroffen. Somit gilt es, durch entsprechende Anpassung der perioperativen Medikation, diese Inzidenz weiter zu reduzieren. Studien konnten zeigen, dass bei Kataraktoperationen sowohl das Risiko für ein postoperatives Makulaödem als auch für Schmerzen und Vorderkammerreiz bei Patienten mit perioperativer Applikation von nicht steroidalen Antirheumatika (NSAR) reduziert ist. Somit sollte eine perioperative Gabe von NSAR und Kortikosteroidtropfen erfolgen. Nach Hornhautchirurgie ist eine lokale Steroidtherapie zusätzlich empfohlen, da sie nach lamellärer refraktiver Hornhautchirurgie das Risiko für Hazebildung und tiefer lamellärer Keratitis (DLK) senkt.

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“…Topical NSAIDs are widely used to prevent postoperative cystoid macular edema (CME) in cataract surgery. [ 14 ] Meta-analyses on this role of NSAIDs have found some evidence of their efficacy and suggested that their use alone or in combination with topical steroids may be superior to the use of steroids alone. [ 15 ] They may also be useful in the treatment of pseudophakic CME.…”

Section: Introductionmentioning

confidence: 99%

Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis

Saade

Istambouli

Abdulaal

et al. 2021

Middle East African Journal of Ophthalmology

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PURPOSE: The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME. METHODS: The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later. RESULTS: Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation (P = 1.0 and P = 0.2, respectively). There were a significant improvement in BCVA after 4 months of bromfenac treatment (P = 0.043) and a significant decrease in CRT (P = 0.002). Subretinal fluid resolved completely in 8/9 eyes, and 4/9 eyes had a complete resolution of cystoid macular edema at 4 months. CONCLUSION: Bromfenac may be a useful addition to the treatment of UME.

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The role of perioperative nonsteroidal anti-inflammatory drugs use in cataract surgery

Cited by 15 publications

References 16 publications

Current Management Options in Irvine–Gass Syndrome: A Systemized Review

Current Management Options in Irvine–Gass Syndrome: A Systemized Review

Peri-/Postoperative antientzündliche Therapie nach Kataraktoperation und refraktiver Chirurgie

Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis

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