Effectiveness of Periocular Drug Injection in CATaract Surgery

Launched by LUIGI RONDAS · Dec 2, 2021

Keywords

ClinConnect Summary

In a recent European multicentre study (PREvention of Macular EDema after cataract surgery; PREMED), it was demonstrated that the combination of topical corticosteroids and NSAIDs results in the lowest risk of developing CME after cataract surgery. However, noncompliance with eye drops may compromise the effectiveness of treatment. Noncompliance is often unintentional and related to forgetfulness or incorrect instillation, particularly in the elderly cataract surgery population.

The objective of this study is to evaluate the effectiveness of different treatments to prevent CME after catara...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • who are undergoing routine phacoemulsification (one eye per patient);
• • who are 21 years or older;
• • who should be able to communicate properly and understand instructions.
• • willing and/or able to comply with the scheduled visits and other study procedures.
• Exclusion Criteria:
• • patients who already participated with their contralateral eye;
• • combined surgery (e.g. combined phacoemulsification and trabeculectomy);
• • patients with an increased risk of developing cystoid macular edema (CME) in the study eye (e.g. diabetes mellitus, previous retinal venous occlusion, or a history of uveitis, macular edema, epiretinal membrane, or previous retinal surgery);
• • patients who developed CME after cataract surgery in the contralateral eye;
• • patients with cystoid macular changes in the study eye at baseline;
• • patients with an increased risk of developing perioperative complications (e.g. Fuchs' endothelial dystrophy);
• • patients with permanent moderate visual impairment in the contralateral eye (decimal visual acuity less than 0.3);
• • patients with a history of steroid induced IOP rise or glaucomatous visual field loss;
• • patients using drugs that reduce or increase the risk of macular edema (e.g., periocular or intraocular corticosteroid, NSAID, or antivascular endothelial growth factor (VEGF) injection; topical corticosteroid or NSAID use; systemic corticosteroids (\>= 20mg prednisolon), methotrexate, biologicals, or acetazolamide), or in the previous 4 months;
• • patients with a contraindication for any of the investigated drugs;
• • patients who are cardiovascular unstable;
• • patients who have a history of hyperthyroidism.