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    Combination of NSAIDs and steroids reduces CME outcomes

     

    Patients were followed for 90 days, during which period patients with any finding of CME on examination, any visual complaint, and vision below 20/30 were suspected of having CME and underwent optical coherence tomography (OCT).

    Related: Swept-source OCT affords greater detailing in vitreous imaging

    Dr. Mahootchi reported that in Group 1, the incidence of CME was 1.9%.

    “In Group 2, with an incidence of CME of 1.9%, adding the steroid did not increase the incidence of CME, but adding an intravitreal steroid also did not decrease it,” Dr. Mahootchi said. “This confirmed what other investigators have reported previously. Finally, in Group 3, the incidence of CME was 0%, which was unexpected and stunning.”

    More Cataract: What is the best way to correct congenital cataracts?

    One consideration is that perhaps the Group 3 regimen delays the onset of CME. Therefore, it is unknown what might have happened later than 90 days postoperatively, Dr. Mahootchi noted.

    Related: Pearls for managing tricky cataracts in post-vitrectomy eyes

    “It was really not valid to compare the results after 90 days with everything that I have done previously,” Dr. Mahootchi explained. “But, we kept counting and concluded that if using a transzonular steroid and an antibiotic at the time of surgery, it is probably beneficial to use an NSAID drop postoperatively to reduce the incidence of CME. However, when we looked at 566 patients who were given only an NSAID in the postoperative period, the incidence of CME increased to only 0.5%. Adding NSAID drops to a transzonular steroid improves CME outcomes overall.”

     

    Ahad Mahootchi, MD

    P: 813/779-3338

    This article was adapted from Dr. Mahootchi’s presentation at the 2015 meeting of the American Academy of Ophthalmology. He is a speaker for Imprimis Pharmaceuticals.

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