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65 EW RESIDENTS April 2018 decreased CST and reduced presence of CME supports the continued use of combination therapy. Moreover, there are other ancillary benefits of this approach, including a reduction in injection, prostaglandin-induced miosis, anterior segment inflamma- tion, and postoperative pain. 10 It is important to note, however, that the study criteria included exceptionally healthy eyes with no other ocular pathology. This group theoretically would benefit the least from post- operative prophylaxis therapy. It is possible that the effects of combina- tion therapy may be more robust in less healthy cases. In summary, these two prospec- tive randomized studies contribute important findings to the literature regarding adjuvant topical NSAIDs after cataract surgery, albeit mostly for low risk patients. Both studies demonstrated that the presence of macular thickening was less like- ly after the use of postoperative NSAIDs, but the long-term benefit of treatment, particularly on final vi- sual acuity, is not clear. Importantly, neither study investigated the use of adjuvant topical NSAIDs in patients with risk factors for ME such as diabetic retinopathy, and neither demonstrated a significant differ- ence in the effect of macular edema on final visual acuity. Consequently, while these studies demonstrate that NSAIDs may reduce postoperative CST, neither study has definitely demonstrated NSAIDs significantly aid in the prevention of significant macular edema or contribute to superior visual outcomes. As such, neither study strongly compels a shift from current practice patterns. Further prospective trials will be needed to elucidate if there is a clear benefit to the used of these agents postoperatively. EW References 1. Kim SJ, et al. Topical nonsteroidal anti-in- flammatory drugs and cataract surgery: A report by the American Academy of Ophthal- mology. Ophthalmology. 2015;122:2159–68. 2. Packer M, et al. Incidence of acute postoperative cystoid macular edema in clinical practice. J Cataract Refract Surg. 2012;38:2108–11. 3. Chu CJ, et al. Risk factors and incidence of macular edema after cataract surgery: A database study of 81984 eyes. Ophthalmolo- gy. 2016;123:316–23. 4. Lobo C. Pseudophakic cystoid macular edema. Ophthalmologica. 2012;227:61–67. 5. Hoffman RS, et al. Cataract surgery and nonsteroidal antiinflammatory drugs. J Cata- ract Refract Surg. 2016;42:1368–1379. 6. Lim BX, et al. Prophylactic non-steroidal anti-inflammatory drugs for the preven- tion of macular oedema after cataract surgery. Cochrane Database Syst Rev. 2016;11:CD006683. 7. Wielders LH, et al. Prevention of cystoid macular edema after cataract surgery in non- diabetic and diabetic patients: A systematic review and meta-analysis. Am J Ophthalmol. 2015;160:968–981. 8. Kessel L, et al. Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops: a systematic review. Ophthalmology. 2014;121:1915–24. 9. Juthani VV, et al. Non-steroidal anti-in- flammatory drugs versus corticosteroids for controlling inflammation after uncomplicated cataract surgery. Cochrane Database Syst Rev. 2017;7:CD010516. 10. McCafferty S, et al. Pseudophakic cystoid macular edema prevention and risk factors; prospective study with adjunctive once daily topical nepafenac 0.3% versus placebo. BMC Ophthalmol. 2017;17:16 Contact information Fredrick: dfred@stanford.edu Washington, DC 2018 Aerie Pharmaceuticals Alcon Laboratories Inc. Allergan Inc. Bausch + Lomb Carl Zeiss Meditec Glaukos Corporation Johnson & Johnson Vision New World Medical Santen Shire Sun Pharmaceuticals Zeimer Thank you for providing unrestricted educational grants: Glaukos Corporation Allergan Inc. Thank you for supporting our ASCRS-Authorized Education Programs: Alcon Laboratories Inc. Avedro Bausch + Lomb Carl Zeiss Meditec Epsilon USA Haag-Streit Diagnostics MicroSurgical Technology New World Medical OCULUS Inc. Thank you for your sponsorship of the EyeWorld Corporate Events: EW 2018 Thank you_island.qxp_EW 2018 Thank You 3/22/18 11:11 AM Page 1

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