European multicenter trial of the prevention of cystoid macular edema after cataract surgery in nondiabetics: ESCRS PREMED study report 1

Laura H. P. Wielders*, Jan S. A. G. Schouten, Bjorn Winkens, Frank J. H. M. van den Biggelaar, Claudette A. Veldhuizen, Oliver Findl, Joaquim C. N. Murta, Willem R. O. Goslings, Marie-Jose Tassignon, Maurits V. Joosse, Ype P. Henry, Alexander H. F. Rulo, Jose L. Guell, Michael Amon, Thomas Kohnen, Rudy M. M. A. Nuijts, ESCRS PREMED Study Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose: To compare the efficacy of a topical nonsteroidal antiinflammatory drug, topical corticosteroid, and a combination of both drugs to prevent the occurrence of cystoid macular edema (CME) after cataract surgery in nondiabetic patients. Setting: Twelve European study centers. Design: Randomized clinical trial. Methods: Nondiabetic patients having uneventful cataract surgery were included in this study. Patients were randomized to receive topical bromfenac 0.09% twice daily for 2 weeks or dexamethasone 0.1% 4 times daily with 1 drop less per day every following week, or a combination of both. The primary outcome was the difference in central subfield mean macular thickness 6 weeks postoperatively. Secondary outcome measures included corrected distance visual acuity as well as the incidence of CME and clinically significant macular edema (CSME) within 6 weeks and 12 weeks postoperatively. Results: This study comprised 914 patients. Six weeks postoperatively, the central subfield mean macular thickness was 288.3 gm, 296.0 gm, and 284.5 gm in the bromfenac group, dexamethasone group, and combination treatment group, respectively (overall P = .006). The incidence of clinically significant macular edema within 12 weeks postoperatively was 3.6%, 5.1%, and 1.5%, respectively (overall P = .043). Conclusion: Patients treated with a combination of topical bromfenac 0.09% and dexamethasone 0.1% had a lower risk for developing CSME after cataract surgery than patients treated with a single drug. (C) 2018 ASCRS and ESCRS
Original languageEnglish
Pages (from-to)429-439
Number of pages11
JournalJournal of Cataract and Refractive Surgery
Issue number4
Publication statusPublished - 1 Apr 2018
Event35th Congress of the European-Society-of-Cataract-and-Refractive-Surgeons (ESCRS) - Lisbon, PORTUGAL, Lisbon
Duration: 1 Apr 2018 → …


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