From the University Eye Clinic Maastricht (Wielders, Schouten, Aberle, Lambermont, van den Biggelaar, Simons, Nuijts), Maastricht University Medical Center, and the Department of Methodology and Statistics, Maastricht University (Winkens), Maastricht, the Netherlands.
From the University Eye Clinic Maastricht (Wielders, Schouten, Aberle, Lambermont, van den Biggelaar, Simons, Nuijts), Maastricht University Medical Center, and the Department of Methodology and Statistics, Maastricht University (Winkens), Maastricht, the Netherlands.
J Cataract Refract Surg. 2017 Feb;43(2):276-284. doi: 10.1016/j.jcrs.2016.06.041.
The purpose of this review was to determine the optimum pharmacologic treatment for cystoid macular edema (CME) after cataract surgery in nondiabetic and diabetic patients. The Cochrane Library, Medline, and Embase databases were searched, and all randomized controlled trials (RCTs) that compared at least 2 pharmacologic strategies for CME after cataract surgery were included. Studies were excluded if preoperative CME or other risk factors for developing CME postoperatively were present. Ten RCTs were included in the systematic review. Five trials included at least 30 participants. Three RCTs showed a greater visual acuity improvement in patients treated with topical nonsteroidal antiinflammatory drugs (NSAIDs) than with a placebo. Other studies comparing the efficacy of topical NSAIDs, topical corticosteroids, sub-Tenon corticosteroids, oral NSAIDs, and oral acetazolamide did not report significant differences between treatment groups. Therefore, large RCTs are needed to provide evidence-based recommendations for the optimum treatment of CME after cataract surgery.
本综述旨在确定非糖尿病和糖尿病患者白内障手术后囊样黄斑水肿 (CME) 的最佳药物治疗方法。检索了 Cochrane 图书馆、Medline 和 Embase 数据库，并纳入了比较白内障手术后 CME 的至少 2 种药物治疗策略的所有随机对照试验 (RCT)。如果存在术前 CME 或其他术后发生 CME 的风险因素，则排除研究。系统评价纳入了 10 项 RCT。其中 5 项试验至少纳入了 30 名参与者。3 项 RCT 显示，接受局部非甾体抗炎药 (NSAID) 治疗的患者视力改善程度大于安慰剂。其他比较局部 NSAID、局部皮质类固醇、Tenon 下皮质类固醇、口服 NSAID 和口服乙酰唑胺疗效的研究未报告治疗组之间存在显著差异。因此，需要进行大型 RCT 为白内障手术后 CME 的最佳治疗提供循证建议。
