Li Shan-Shan, Wang Hui-Hui, Wang Yan-Ling, Zhang Da-Wei, Chen Xi
Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Int Ophthalmol. 2023 Jan;43(1):271-284. doi: 10.1007/s10792-022-02426-y. Epub 2022 Sep 6.
To compare the efficacy and safety of non-steroidal anti-inflammatory drugs (NSAID), corticosteroid (CS), and a combination of both drugs to prevent cystoid macular edema (CME) after cataract surgery.
We searched Pubmed, Cochrane Library, and Embase electronic databases to assess the relevant randomized controlled trials (RCTs) up to 28 April 2021. Network meta-analysis was registered on PROSPERO (CRD42020182520).
Twenty-four RCTs were included in this review. The NSAID and combination of both drugs were significantly reduced the risk of developing CME than CS alone in non-diabetics and mix populations. In the ranking profiles, the combination therapy showed a significant advantage over the single drugs and was less likely to develop CME. Diclofenac was the most likely to reduce the odds of developing CME compared with bromfenac and nepafenac. Dexamethasone was the most likely to reduce the odds of developing CME compared with betamethasone and fluorometholone.
NSAID combination with CS has significantly reduced the risk of developing CME postoperatively than the single drug. Diclofenac was superior to bromfenac and nepafenac in preventing CME. Dexamethasone was superior to betamethasone and fluorometholone in preventing CME.
比较非甾体抗炎药（NSAID）、皮质类固醇（CS）以及两者联合用药预防白内障手术后黄斑囊样水肿（CME）的疗效和安全性。
检索截至2021年4月28日的Pubmed、Cochrane图书馆和Embase电子数据库，以评估相关随机对照试验（RCT）。网络荟萃分析已在PROSPERO（CRD42020182520）注册。
本综述纳入了24项RCT。在非糖尿病患者和混合人群中，NSAID以及两者联合用药相比单独使用CS能显著降低发生CME的风险。在排序图中，联合治疗比单一药物显示出显著优势，且发生CME的可能性更小。与溴芬酸和奈帕芬酸相比，双氯芬酸最有可能降低发生CME的几率。与倍他米松和氟米龙相比，地塞米松最有可能降低发生CME的几率。
NSAID与CS联合用药相比单一药物能显著降低术后发生CME的风险。在预防CME方面，双氯芬酸优于溴芬酸和奈帕芬酸。在预防CME方面，地塞米松优于倍他米松和氟米龙。
