Cystoid macular edema prophylaxis in cataract surgery: A protocol for network meta-analysis.

Area of Science:

• Ophthalmology
• Pharmacology
• Evidence-based medicine

Background:

• Cataracts are a leading cause of preventable blindness globally.
• Cystoid macular edema (CME) is a common complication after cataract surgery, impacting patient quality of life and incurring healthcare costs.
• Clinical equipoise exists regarding the optimal prophylactic treatment for post-cataract surgery CME.

Purpose of the Study:

• To synthesize evidence from randomized controlled trials on prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) versus corticosteroids for post-cataract surgery CME.
• To compare the effectiveness of specific NSAID and corticosteroid regimens on key outcomes.
• To evaluate impacts on retinal thickness, visual acuity, CME development, quality of life, intraocular pressure, and adverse events.

Main Methods:

• A systematic review and random-effects Bayesian network meta-analysis (NMA) will be conducted.
• Searches will cover MEDLINE, EMBASE, CENTRAL, ClinicalTrials.gov, and WHO registries.
• Data on seven outcomes (retinal thickness, visual acuity, CME rate, clinically significant macular edema, quality of life, intraocular pressure, adverse events) will be synthesized at 6 weeks and 3 months post-surgery. Certainty of evidence will be assessed using GRADE NMA guidelines.

Main Results:

• The NMA will provide a comparative evaluation of different prophylactic treatment regimens.
• Results will quantify the effectiveness of NSAIDs and corticosteroids on specific ophthalmological and patient-reported outcomes.
• The analysis will identify potential differences in safety profiles and adverse events between treatment groups.

Conclusions:

• This network meta-analysis will offer a comprehensive evidence-based assessment for managing post-cataract surgery CME.
• Findings will inform clinical decision-making regarding the optimal prophylactic strategy.
• The study addresses a critical question with significant clinical equipoise, aiming to improve patient outcomes and reduce healthcare burdens.