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    Steroid and NSAID combination prevents macular oedema after cataracts

    A combination of a topical corticosteroid and a nonsteroidal anti-inflammatory drug (NSAID) is more effective than either one alone in reducing the risk of cystoid macular oedema (CME) after cataract surgery in nondiabetic patients, researchers say.

    “The results were a little bit unexpected,” said Dr Rudy Nuijts, associate professor of ophthalmology at the University of Maastricht, the Netherlands, in a video release from the European Society of Cataract and Refractive Surgeons (ESCRS).

    He presented the finding at the 35th ESCRS Congress in Lisbon, Portugal, in October.

    The ESCRS PREvention of Macular EDema after cataract surgery (PREMED) study was the first international multicentre randomised controlled clinical trial specifically designed to determine the best way to prevent of CME after cataract surgery, Dr Nuijts said. ESCRS provided funding for the research.

    CME is one of the most prevalent postoperative complications in cataract surgery, especially in the diabetic population, where the incidence can be as high as 31%, he said. But opinions have differed on the best prophylaxis.

    For example, the American Academy of Ophthalmology (AAO) in 2015 stated that “there is a lack of level 1 evidence that supports the long-term visual benefit of NSAID therapy when applied solely or in combination with corticoid therapy”.1

    However, the following year, Hoffman et al. wrote that “whether used alone, synergistically with steroids, or for specific high-risk eyes, the efficacy of NSAIDS is compelling.”2

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