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Fatima K. Ahmad, Brad Feldman, Lisa A. Hark, Sana Haq, Brianna E. Kenney, Catherine E. Callinan, Yang Dai; Effect of Prophylactic Nonsteroidal Anti-Inflammatory Drugs on Pseudophakic Cystoid Macular Edema in a Series of Patients on the Wills Eye Cataract and Primary Eye Care Service. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6691.
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To determine if the use of prophylactic topical nonsteroidal anti-inflammatory drugs (NSAIDs) has decreased the rate of development of cystoid macular edema (CME) following cataract surgery.
Retrospective review of a cohort of patients on the Wills Eye resident cataract service who underwent cataract surgery between 2007 and 2010. Patients were excluded if there was less than 28 days of follow-up after surgery and preexisting macular edema. Data collection included patient demographics, systemic and ocular comorbidities, topical medication use, surgical complications, Snellen best corrected visual acuities (BCVA) for up to one year postoperatively, and diagnosis and treatment of CME.
A total of 925 operated eyes of 700 patients were reviewed. Twelve patients had preoperative macular edema and 33 patients were excluded because of less than 28 days of follow-up. In patients meeting inclusion criteria, 234 eyes (27%) did not receive perioperative NSAID, while 648 eyes (73%) did receive an NSAID. Twenty-nine patients developed pseudophakic CME (3.3%). Rates of CME in the two subgroups were 3.2% and 3.4% respectively (p=0.55).
In this patient population, there was not a statistically significant decrease in rate of CME in patients who received NSAIDs. Prophylactic use of topical NSAIDs may be reserved for use in patients who are at higher risk of developing CME, and may not be cost-effective for patients undergoing routine cataract surgery.
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