title: The comparative efficacy and safety of topical non-steroidal anti-inflammatory drugs for the treatment of anterior chamber inflammation after cataract surgery: a systematic review and network meta-analysis.
abstract: OBJECTIVE
  Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of anti-inflammatory drugs that are used in ophthalmologic surgery. These drugs do not have a steroid structure, but can inhibit surgery-induced miosis, anterior chamber inflammation, and cystoid macular edema (CME). However, the application of NSAIDs remains controversial. Therefore, we performed a meta-analysis to assess the efficacy and safety of NSAIDs for the treatment of anterior chamber inflammation after cataract surgery.
  
  
  METHODS
  Relevant articles were identified from the PubMed, Embase, and Cochrane databases up to October 2016. The therapeutic effect of NSAIDs on anterior chamber inflammation was evaluated. The important outcomes of overall anterior chamber inflammation, freedom from ocular pain, and treatment-related/serious ocular adverse events were analyzed by using a random-effects network meta-analysis. The quality of evidence was assessed via the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach.
  
  
  RESULTS
  A total of 19 trials assessing 7,234 patients were included in our meta-analysis. Diclofenac was the most likely to improve anterior chamber inflammation after cataract surgery, followed by nepafenac, ketorolac, bromfenac, and flurbiprofen. Nepafenac was most likely to improve postoperative ocular pain relief, followed by bromfenac and ketorolac. Our analysis of treatment-related/serious ocular adverse events revealed that piroxicam was most likely to have the fewest related adverse events, but the robustness of this finding was low. Diclofenac was another near-ideal drug, followed by nepafenac, bromfenac, and ketorolac.
  
  
  CONCLUSIONS
  NSAIDs are effective drugs compared to placebos for the relief of anterior chamber inflammation. Furthermore, diclofenac, nepafenac, ketorolac, and bromfenac demonstrated relatively greater significant effects than those of other NSAIDs.
authors.affiliation: Department of Ophthalmology, The Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.|Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing City, 400038, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Duan
authors.affiliation: Department of Ophthalmology, The Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.|Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing City, 400038, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, The Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. lijiawen861@sina.com.|Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing City, 400038, China. lijiawen861@sina.com.
authors.forename: Jiawen
authors.initials: J
authors.lastname: Li
mesh_terms: D000287:Administration, Topical; D000867:Anterior Chamber / Q000473:pathology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D013530:Surgical Wound Infection / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Anterior chamber inflammation; Cataract surgery; Meta-analysis; Non-steroidal anti-inflammatory drugs