Rate of pseudophakic cystoid macular edema using intraoperative and topical nonsteroidal antiinflammatory drugs alone without steroids

J Cataract Refract Surg. 2020 Mar;46(3):350-354. doi: 10.1097/j.jcrs.0000000000000062.

Abstract

Purpose: To determine the rate of postoperative cystoid macular edema (CME) in patients undergoing cataract surgery treated with intraoperative intracameral and postoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) without steroids.

Setting: Academic outpatient surgery center Wake Forest Baptist Health in Bermuda Run, NC.

Design: Retrospective cohort study.

Methods: A retrospective chart review was performed. Patients were identified through a medical record search tool using criteria of the Current Procedural Terminology code (66984), a single surgeon, and a date range from January 1, 2016, through December 31, 2017. Medical records were reviewed to determine intraoperative and postoperative medication regimen, visual outcome, and development of postoperative CME. Patients with a history of uveitis, diabetic macular edema, retinal vein occlusions, epiretinal membranes, vitreomacular traction, or any prior macular edema were excluded. In addition, any patients with less than 6 weeks of postoperative follow-up were excluded.

Results: Overall, 824 patient records were reviewed, and the analysis included 504 eyes. Of these, 2 eyes developed postoperative CME (rate = 0.40%, 95% CI 0.0005 to 0.0143).

Conclusions: The rate of CME in patients treated with intraoperative and postoperative NSAIDs without steroids was low and below the historical rates derived from a literature review of CME development with the use of steroids.

MeSH terms

  • Administration, Ophthalmic
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Benzophenones / therapeutic use
  • Bromobenzenes / therapeutic use
  • Female
  • Humans
  • Intraoperative Care
  • Ketorolac / therapeutic use
  • Macular Edema / epidemiology*
  • Macular Edema / prevention & control
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Phacoemulsification*
  • Phenylephrine / therapeutic use
  • Postoperative Care
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Pseudophakia / etiology*
  • Retrospective Studies
  • Visual Acuity

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Benzophenones
  • Bromobenzenes
  • Ophthalmic Solutions
  • Phenylephrine
  • bromfenac
  • Ketorolac