Shan-Shan Li1, Hui-Hui Wang2, Yan-Ling Wang3, Da-Wei Zhang4, Xi Chen5. 1. Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China. shanshanli@ccmu.edu.com. 2. Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. 3. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. 4. Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China. 5. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. xichen@ccmu.edu.cn.
Abstract
INTRODUCTION: To compare the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAID), corticosteroid (CS), and a combination of both drugs to prevent cystoid macular edema (CME) after cataract surgery. METHODS: We searched Pubmed, Cochrane Library, and Embase electronic databases to assess the relevant randomized controlled trials (RCTs) up to 28 April 2021. Network meta-analysis was registered on PROSPERO (CRD42020182520). RESULTS: Twenty-four RCTs were included in this review. The NSAID and combination of both drugs were significantly reduced the risk of developing CME than CS alone in non-diabetics and mix populations. In the ranking profiles, the combination therapy showed a significant advantage over the single drugs and was less likely to develop CME. Diclofenac was the most likely to reduce the odds of developing CME compared with bromfenac and nepafenac. Dexamethasone was the most likely to reduce the odds of developing CME compared with betamethasone and fluorometholone. CONCLUSION: NSAID combination with CS has significantly reduced the risk of developing CME postoperatively than the single drug. Diclofenac was superior to bromfenac and nepafenac in preventing CME. Dexamethasone was superior to betamethasone and fluorometholone in preventing CME.
INTRODUCTION: To compare the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAID), corticosteroid (CS), and a combination of both drugs to prevent cystoid macular edema (CME) after cataract surgery. METHODS: We searched Pubmed, Cochrane Library, and Embase electronic databases to assess the relevant randomized controlled trials (RCTs) up to 28 April 2021. Network meta-analysis was registered on PROSPERO (CRD42020182520). RESULTS: Twenty-four RCTs were included in this review. The NSAID and combination of both drugs were significantly reduced the risk of developing CME than CS alone in non-diabetics and mix populations. In the ranking profiles, the combination therapy showed a significant advantage over the single drugs and was less likely to develop CME. Diclofenac was the most likely to reduce the odds of developing CME compared with bromfenac and nepafenac. Dexamethasone was the most likely to reduce the odds of developing CME compared with betamethasone and fluorometholone. CONCLUSION: NSAID combination with CS has significantly reduced the risk of developing CME postoperatively than the single drug. Diclofenac was superior to bromfenac and nepafenac in preventing CME. Dexamethasone was superior to betamethasone and fluorometholone in preventing CME.
Authors: Colin J Chu; Robert L Johnston; Charlotte Buscombe; Ahmed B Sallam; Queresh Mohamed; Yit C Yang Journal: Ophthalmology Date: 2015-12-08 Impact factor: 12.079