title: Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: a systematic review.
abstract: OBJECTIVE
  Favorable outcome after cataract surgery depends on proper control of the inflammatory response induced by cataract surgery. Pseudophakic cystoid macular edema is an important cause of visual decline after uncomplicated cataract surgery.
  
  
  METHODS
  We compared the efficacy of topical steroids with topical nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling inflammation and preventing pseudophakic cystoid macular edema (PCME) after uncomplicated cataract surgery.
  
  
  METHODS
  Patients undergoing uncomplicated surgery for age-related cataract.
  
  
  METHODS
  We performed a systematic literature search in Medline, CINAHL, Cochrane, and EMBASE databases to identify randomized trials published from 1996 onward comparing topical steroids with topical NSAIDs in controlling inflammation and preventing PCME in patients undergoing phacoemulsification with posterior chamber intraocular lens implantation for age-related cataract.
  
  
  METHODS
  Postoperative inflammation and pseudophakic cystoid macular edema.
  
  
  RESULTS
  Fifteen randomized trials were identified. Postoperative inflammation was less in patients randomized to NSAIDs. The prevalence of PCME was significantly higher in the steroid group than in the NSAID group: 3.8% versus 25.3% of patients, risk ratio 5.35 (95% confidence interval, 2.94-9.76). There was no statistically significant difference in the number of adverse events in the 2 treatment groups.
  
  
  CONCLUSIONS
  We found low to moderate quality of evidence that topical NSAIDs are more effective in controlling postoperative inflammation after cataract surgery. We found high-quality evidence that topical NSAIDs are more effective than topical steroids in preventing PCME. The use of topical NSAIDs was not associated with an increased events. We recommend using topical NSAIDs to prevent inflammation and PCME after routine cataract surgery.
authors.affiliation: Department of Ophthalmology, Copenhagen University Hospital Glostrup, Glostrup, Denmark; Danish Health and Medicines Authority, Copenhagen, Denmark. Electronic address: line.kessel@dadlnet.dk.
authors.forename: Line
authors.initials: L
authors.lastname: Kessel
authors.affiliation: Danish Health and Medicines Authority, Copenhagen, Denmark.
authors.forename: Britta
authors.initials: B
authors.lastname: Tendal
authors.affiliation: Danish Health and Medicines Authority, Copenhagen, Denmark; The Nordic Cochrane Center, Rigshospitalet, Department 7811, Copenhagen, Denmark.
authors.forename: Karsten Juhl
authors.initials: KJ
authors.lastname: Jørgensen
authors.affiliation: Department of Ophthalmology, Næstved Hospital, Næstved, Denmark.
authors.forename: Ditte
authors.initials: D
authors.lastname: Erngaard
authors.affiliation: Odense Eye Clinic, Odense, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Flesner
authors.affiliation: Skanderborg Eye Clinic, Skanderborg, Denmark.
authors.forename: Jens Lundgaard
authors.initials: JL
authors.lastname: Andresen
authors.affiliation: Department of Ophthalmology, Aarhus University Hospital NBG, Aarhus, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hjortdal
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002387:Cataract Extraction / Q000009:adverse effects*; D006801:Humans; D008269:Macular Edema / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal