Prevention of macular edema after cataract surgery

Laura H. P. Wielders*, Jan S. A. G. Schouten, Rudy M. M. A. Nuijts

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

21 Citations (Web of Science)

Abstract

Purpose of review Although cataract surgery can effectively restore visual function in many patients with cataract, PCME remains an important cause of suboptimal visual acuity. The present review provides an overview of the current literature on the prevention and treatment of PCME. Recent findings Optimal prevention of PCME starts preoperatively with a personalized risk assessment. Diabetes mellitus, retinal vein occlusion, epiretinal membrane, macular hole, and uveitis are the most important risk factors for developing cystoid macular edema after cataract surgery. Topical NSAIDs either in addition to, or instead of, topical corticosteroids reduce the risk of developing PCME. Additional intravitreal corticosteroid and antivascular endothelial growth factor injections have been studied in patients with diabetes. Timely diagnosis and treatment of PCME is essential. Topical NSAIDs solely, or in addition to corticosteroids, improve visual acuity in patients with PCME. Oral acetazolamide and intravitreal dexamethasone implants have been used in refractory cases. Summary Topical NSAIDs can be used solely, or in combination with topical corticosteroids, to prevent and treat PCME. Further research is needed to compare the efficacy of various NSAIDs, and to investigate the cost-effectiveness and long-term benefit of anti-inflammatory treatments on visual acuity, contrast sensitivity, and quality of life.
Original languageEnglish
Pages (from-to)48-53
Number of pages6
JournalCurrent Opinion in Ophthalmology
Volume29
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • cataract surgery
  • cystoid macular edema
  • prevention
  • risk factors
  • treatment
  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • KETOROLAC TROMETHAMINE
  • NEPAFENAC 0.1-PERCENT
  • DIABETIC-RETINOPATHY
  • RISK-FACTORS
  • INTRAVITREAL BEVACIZUMAB
  • TOPICAL INDOMETHACIN
  • COMBINATION THERAPY
  • OCULAR INFLAMMATION
  • VISUAL-ACUITY

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