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    Combination of NSAIDs and steroids reduces CME outcomes

    Zephyrhills, FL—A hot topic in cataract surgery is alternative ways to administer perioperative medications with the goal of lowering the incidence of cystoid macular edema (CME). One way to achieve that goal would be the combination of non-steroidal anti-inflammatory drugs (NSAIDs) and transzonular steroids.

    Related: Switch to laser cataract surgery optimizes outcomes

    “When considering steroids versus non-steroidals versus drops, many of us were trained to use antibiotic steroid and non-steroidal drops before surgery,” Ahad Mahootchi, MD, said. “However, there has been a trend to start using some of these medications in the eye.”

    Based on this principle, Dr. Mahootchi had the idea to compare the incidence of CME postoperatively in cases in which steroid or NSAID drops were added to transzonular triamcinolone, moxifloxacin, and vancomycin. “I wanted to see if giving the steroid first, and then the NSAID, made any difference in the incidence of CME.”

    More cataract: A complicated case of iatrogenic zonular disinertion

    Comparative study

    To determine the benefits of this approach, Dr. Mahootchi, in private practice at Zephyrhills, FL, conducted a single-surgeon comparative case series that include 415 patients in each of three groups:

    More: How to manage cataracts with ocular surface disease

    • Traditional approach of steroidal and NSAID antibiotic drops administered postoperatively and no transzonular medications;

    • Transzonular medications with steroid drops (prednisolone acetate) administered postoperatively;

    • Transzonular medications with NSAID drops (generic ketorolac) administered postoperatively.


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