title: Prevention of Cystoid Macular Edema After Cataract Surgery in Nondiabetic and Diabetic Patients: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the optimum medical strategy to prevent cystoid macular edema (CME) after cataract surgery.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  setting: Cochrane, MEDLINE, and EMBASE databases were searched to identify eligible randomized controlled trials (RCTs).
  
  
  METHODS
  RCTs comparing medical strategies to prevent CME after uncomplicated cataract surgery in nondiabetic and diabetic patients.
  
  
  METHODS
  Data were extracted by 2 authors independently. Quality of individual RCTs was assessed using the Cochrane Collaboration's tool for assessing risk of bias and Delphi criteria.
  
  
  METHODS
  Odds of developing CME within 3 months postoperatively and foveal thickness, macular volume and corrected distance visual acuity change within 3 months postoperatively, as compared to baseline.
  
  
  RESULTS
  Seventeen trials reported incidence rates. Topical nonsteroidal anti-inflammatory drugs (NSAIDs) significantly reduced the odds of developing CME as compared to topical corticosteroids in nondiabetic (odds ratio [OR] 0.11; 95% confidence interval [95% CI] 0.03-0.37) and mixed populations (OR 0.05; 95% CI 0.02-0.11). A combination of topical corticosteroids and NSAIDs significantly reduced the odds of developing CME as compared to topical corticosteroids in nondiabetic (OR 0.21; 95% CI 0.10-0.44) and diabetic patients (OR 0.17; 95% CI 0.05-0.50). Intravitreal corticosteroid or anti-vascular endothelial growth factor injections did not show any additional benefit in diabetic subjects.
  
  
  CONCLUSIONS
  Topical NSAIDs significantly reduced the odds of developing CME, as compared to topical corticosteroids, in nondiabetic and mixed populations. A combination of topical NSAIDs and corticosteroids reduced the odds of developing CME in nondiabetic and diabetic patients, as compared to topical corticosteroids.
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands. Electronic address: laura.wielders@mumc.nl.
authors.forename: Laura H P
authors.initials: LH
authors.lastname: Wielders
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands.
authors.forename: Verena A
authors.initials: VA
authors.lastname: Lambermont
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands.
authors.forename: Jan S A G
authors.initials: JS
authors.lastname: Schouten
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands.
authors.forename: Frank J H M
authors.initials: FJ
authors.lastname: van den Biggelaar
authors.affiliation: Kleijnen Systematic Reviews Ltd, York, United Kingdom.
authors.forename: Gill
authors.initials: G
authors.lastname: Worthy
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands.
authors.forename: Rob W P
authors.initials: RW
authors.lastname: Simons
authors.affiliation: Department of Methodology and Statistics, Maastricht University, Maastricht, Netherlands.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Winkens
authors.affiliation: University Eye Clinic Maastricht UMC+, Maastricht University Medical Center+, Maastricht, Netherlands.
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000009:adverse effects*; D003920:Diabetes Mellitus; D014943:Global Health; D006801:Humans; D015994:Incidence; D008269:Macular Edema / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis
chemical_list: D000893:Anti-Inflammatory Agents