Optical coherence tomography (OCT) analysis of cystoid macular edema (CME) which is a well-known surgical consequence, reveals central subfield macular thickness, cystic hyporeflective lesions, and subfoveal fluid. CME that after cataract surgery is known as PCME. It is thought to be the most frequent reason for vision decline following surgery. The main theory for PCME is mechanical manipulation linked to the release of inflammatory mediators.
In order to successfully lower the incidence of PCME, no standardized preventive procedure has been developed as of yet. So, Abdullah Alqahtani and his colleagues evaluated the safety and effectiveness of corticosteroids and nonsteroidal anti-inflammatory drops in preventing PCME. This study included randomized controlled trials (RCTs) that examined the effectiveness of NSAID against placebo, steroid, or NSAID + steroid against placebo which indicated the prevalence of macular thickness, PCME, and best-corrected visual acuity.
This analysis included a total of 18 RCTs (n = 2959). 2 RCTs had a high risk of bias, 7 RCTs had an unknown risk of bias, and 9 RCTs had a low risk. NSAID-treated individuals had a considerably decreased incidence of cystoid macular edema (RR = 0.33, P < 0.001). According to subgroup analysis, individuals using NSAIDs alone had a statistically significant lower probability of developing edema than other patients (P < 0.001). NSAIDs were linked to noticeably lower mean corrected visual acuity values (P < 0.001) by using LogMar.
The findings from this systematic review and meta-analysis revealed that NSAIDs, either by themselves or in conjunction with steroids, are effective preventative interventions that can lower the incidence of PCME. However, a variety of circumstances, such as intraoperative problems, ocular or systemic disorders, and surgical manipulation, contribute to its pathogenesis. Standardized preventive procedures are therefore required for every patient group, including those who are healthy, have ocular disorders, and have systemic diseases.
Source:
Alqahtani, A. S., Hersi, R. M., Homsi, J. J., Alamoudi, L. O., Alghamdi, S., Alrajhi, R. K., & AlJehani, R. A. (2024). Prophylactic regimens for the prevention of pseudophakic cystoid macular edema: systematic review and meta-analysis. In International Journal of Retina and Vitreous (Vol. 10, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s40942-024-00588-8
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.