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Treatment of cystoid macular edema after cataract surgery
Laura H P Wielders1, Jan S A G Schouten1, Merel R Aberle1
1From the University Eye Clinic Maastricht (Wielders, Schouten, Aberle, Lambermont, van den Biggelaar, Simons, Nuijts), Maastricht University Medical Center, and the Department of Methodology and Statistics, Maastricht University (Winkens), Maastricht, the Netherlands.
Abstract:
The purpose of this review was to determine the optimum pharmacologic treatment for cystoid macular edema (CME) after cataract surgery in nondiabetic and diabetic patients. The Cochrane Library, Medline, and Embase databases were searched, and all randomized controlled trials (RCTs) that compared at least 2 pharmacologic strategies for CME after cataract surgery were included. Studies were excluded if preoperative CME or other risk factors for developing CME postoperatively were present. Ten RCTs were included in the systematic review. Five trials included at least 30 participants. Three RCTs showed a greater visual acuity improvement in patients treated with topical nonsteroidal antiinflammatory drugs (NSAIDs) than with a placebo. Other studies comparing the efficacy of topical NSAIDs, topical corticosteroids, sub-Tenon corticosteroids, oral NSAIDs, and oral acetazolamide did not report significant differences between treatment groups. Therefore, large RCTs are needed to provide evidence-based recommendations for the optimum treatment of CME after cataract surgery.