Prevention of macular edema after cataract surgery

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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.

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