The use of nonsteroidal anti-inflammatory drugs (NSAIDs) before and after cataract surgery significantly lowers the incidence of cystoid macular edema (CME) and provides patients with better quality of vision. The results of three studies presented at the annual meeting of the American Society of Cataract and Refractive Surgery, San Francisco, bore out that finding.
"Over the last year, we have seen a revolution with multifocal IOLs gaining increasing popularity with patients. Patients expect to have optimal outcomes with these IOLs, and topical NSAIDs have been shown to optimize their outcomes by producing less CME, less pain and inflammation, and shorter surgical times," Eric D. Donnenfeld, MD, explained. "The administration of topical NSAIDs following implantation of conventional IOLs reduces macular thickness and improves contrast sensitivity. NSAIDs may not affect Snellen visual acuity but they have a huge effect on quality of vision."
The investigators evaluated the monocular uncorrected visual acuity (UCVA) and the best-corrected visual acuity (BCVA), mesopic and photopic contrast sensitivity with and without glare, and the foveal thickness and foveal volume 2 weeks after IOL implantation.
Increased foveal thickness
"There was a significant (p <0.001) increase as seen on optical coherence tomography (OCT) in the foveal thickness in the patients not randomly assigned to the NSAID compared with those assigned to the NSAID. Foveal volume may even be a better indicator; the foveal volume showed a significant (p < 0.001) increase in the patients who did not receive the NSAID," Dr. Donnenfeld reported.
Patients treated with ketorolac also had better visual acuity, although the difference between the two groups did not reach significance for either the UCVA (p = 0.292) or the BCVA (p = 0.078).